This document provides an overview of biomedical waste management. It begins with definitions of key terms like biomedical waste and discusses the types of wastes generated from healthcare facilities. It covers the history of regulations around biomedical waste and the key Indian laws from 1998 and 2011. Methods of waste management are summarized, including segregation, treatment approaches like incineration, and final disposal. The roles and responsibilities of waste generators and operators are also mentioned. Overall, the document aims to introduce the topic of biomedical waste management and the approaches and regulations around safe handling of this waste.
STERILIZATION AND DISINFECTION IN A DENTAL CLINIC pptVineetha K
One of the basic things you need to know before starting a dental clinic. This presentation covers the basics of sterilization and disinfection in a dental setting.
STERILIZATION AND DISINFECTION IN A DENTAL CLINIC pptVineetha K
One of the basic things you need to know before starting a dental clinic. This presentation covers the basics of sterilization and disinfection in a dental setting.
This is my recent webinar powerpoint presentation - I was invited as a Featured Speaker for Biomedical Engineering Department students of Karunya Deemed University(Solving Human Problems)- here in my presentation I have highlighted two challenges that we dentists face rightnow to be solved by the University students in hope of spreading the word of challenging situation to be solved - have used this opportunity of this platform to share knowledge & Inspire souls. Thank you.
The Final presentation powerpoint - planning to share on my Linked IN Profile :) #spreadingknowledge #inspiringminds #teaching #solvingproblems #helping #highlightingproblems #suggestingsolutions #knowledge #growing #knowledgeispower #preventionisbetterthancure #spreadingawareness
Have a beautiful Day :) spread love ,Peace & Positivity...
Infection control in dental clinic and management of sterile and contaminated...Arun Mangalathu
Sterilization , Disinfection and management of Instruments in dental clinic, Lecture delivered by Dr Arun George for indian Dental Association ,Malanadu branch during dental Assistance training programme
Cross infection control in dentistry (Few basic points)Sumaiya Hasan
Recently, dentistry has been one of the few reasons of the spread of some major diseases such as hepatitis etc. If proper cross infection control is maintained by taking few precautions then this transfer of diseases can be stopped. This presentation contains only some basic precautions which should be taken to prevent cross infection.
Dentists and dental health care workers may face potential occupational hazards due to exposure risks inherent in the profession . Dental practitioners are at the risk of exposure to blood-borne pathogens like HIV , HBV, HCV. STRESS can never be totally eliminated from dental practise , however it can be managed .
Waste disposal in dental practices f1 / dental implant courses by Indian dent...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
mucogingival surgery or plastic surgery of muco-gingival tissue is a surgical procedure targeted to correct and eliminate anatomic, developmental and traumatic alterations of gingiva.
This is my recent webinar powerpoint presentation - I was invited as a Featured Speaker for Biomedical Engineering Department students of Karunya Deemed University(Solving Human Problems)- here in my presentation I have highlighted two challenges that we dentists face rightnow to be solved by the University students in hope of spreading the word of challenging situation to be solved - have used this opportunity of this platform to share knowledge & Inspire souls. Thank you.
The Final presentation powerpoint - planning to share on my Linked IN Profile :) #spreadingknowledge #inspiringminds #teaching #solvingproblems #helping #highlightingproblems #suggestingsolutions #knowledge #growing #knowledgeispower #preventionisbetterthancure #spreadingawareness
Have a beautiful Day :) spread love ,Peace & Positivity...
Infection control in dental clinic and management of sterile and contaminated...Arun Mangalathu
Sterilization , Disinfection and management of Instruments in dental clinic, Lecture delivered by Dr Arun George for indian Dental Association ,Malanadu branch during dental Assistance training programme
Cross infection control in dentistry (Few basic points)Sumaiya Hasan
Recently, dentistry has been one of the few reasons of the spread of some major diseases such as hepatitis etc. If proper cross infection control is maintained by taking few precautions then this transfer of diseases can be stopped. This presentation contains only some basic precautions which should be taken to prevent cross infection.
Dentists and dental health care workers may face potential occupational hazards due to exposure risks inherent in the profession . Dental practitioners are at the risk of exposure to blood-borne pathogens like HIV , HBV, HCV. STRESS can never be totally eliminated from dental practise , however it can be managed .
Waste disposal in dental practices f1 / dental implant courses by Indian dent...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
mucogingival surgery or plastic surgery of muco-gingival tissue is a surgical procedure targeted to correct and eliminate anatomic, developmental and traumatic alterations of gingiva.
New bio medical waste management rules 2016Gunwant Joshi
Notification of New Bio Medical Waste Management Rules 2016 by MOEF & CC in March 2016 has prompted to launch new presentation on the subject in place of earlier one.
Although 76-90% of the BMW is non-hazardous and harmless as any of the other municipal waste, the remaining 10-26% is hazardous to humans or animals and deleterious to environment. Inappropriate handling of the BMW may have serious public health consequences and the significant impact on the environment. Major hospitals contribute substantially to the quantum of generation of the BMW. Smaller hospitals, the nursing homes, clinics, the pathological laboratories and blood banks also have major contribution to BMW. The common methods adopted for the BMW disposal are incineration and land filling. However, these methods are mainly considered more expensive and less ecofriendly due to their main negative impact on the environment
The waste produced in the course of health care activities carries a higher potential for infection & injury than any other type of waste.
Inadequate & inappropriate handling of health care waste may have serious public health consequences and it has a very significant impact on environment.
Appropriate management of health care waste is thus a crucial component of environmental health protection and it should become an integral feature of health care services.
Biomedical waste management and biohazards by Dr. Sonam AggarwalDr. Sonam Aggarwal
According to biomedical waste (management and Handling rules 1998 of India) –
"bio-medical waste" means any waste, which 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.
https://www.slideshare.net/SonamAggarwal7/biomedical-waste-management-and-biohazards-by-dr-sonam-aggarwal
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
3. INTRODUCTIONINTRODUCTION
Medical and dental care is vital in our life.
Biomedical waste – emerged as an issue of concern.
Biomedical waste is the real problem for the
MAN,COMMUNITY,ENVIRONMENT
Safe, scientific, cost-effective method for biomedical
waste management – need of hour.
4. HISTORY
• In the late 1980’s
– Items such as used syringes washed up on several East Coast
beaches USA
– HIV and HPV virus infection
– Lead to development of Biomedical Waste Management Law in
USA.
• However in India the seriousness about the management
came into lime light only after 1990’s.
5. WHO has estimated that
• In 2000
• Injections with contaminated syringes
caused:
• 21 million hepatitis B virus (HBV)
infections (32% of all new infections);
• Two million hepatitis C virus (HCV)
infections (40% of all new infections);
• 260 000 HIV infections (5% of all new)
6. 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.
7. BIOMEDICAL RULES 1998
• The Government of India as contemplated under Section 6,8
and 25 of the Environment (Protection) Act,1986, has made
the Biomedical Wastes (Management & Handling) Rules,
1998.
• The rules are applicable to every institution generating
biomedical waste which includes hospitals, nursing homes,
clinic, dispensary, veterinary institutions, animal houses,
laboratory, blood bank.
• The rules are applicable to all persons who generate, collect,
receive, store, transport, treat, dispose, or handle bio medical
waste in any form.
8. BIOMEDICAL WASTE(MANAGEMENT &
HANDLING) RULES by Govt. of India, 1998
Revised in 2011
Now known as BMW Rules, 2011
2011 1998
Every occupiergenerating BMW,
irrespective of the quantumof wastes
comes under the BMWRules and
requires to obtain authorisation
Occupiers with more than 1000 beds
required to obtain authorisation
Duties of the operatorlisted Operatorduties absent
Treatment and disposal of BMWmade
mandatory forall the HCEs
Rules restricted to HCEs with more
than 1000 beds
A format forannual report appended
with the Rules
No format forAnnual Report
FormVI i.e. the report of the operator
on HCEs not handing overthe BMW
added to the Rules
FormVI absent
9. Duty of the Occupier
• It is the duty of every occupier i.e. head of an
institution generating bio-medical waste, to take all
steps to ensure that such waste is handled without
any adverse effect to human health and the
environment.
• Provides training to HCW engaged in handling
BMW
10. Duty of the Operator
The operators now have to ensure that the BMW is collected from all
the HCEs and is transported, handled, stored, treated and disposed in
an environmentally sound manner. The operators also have to
inform the prescribed authority in form VI if any HCEs are not
handing the segregated BMW as per the guidelines prescribed in the
rules.
11. Setting up BMW treatment facility
Occupier set up adequate treatment facilities like autoclave / microwave /
incinerator / hydroclave, shredder prior to commencement of its operation or ensure
that the wastes are treated at a common bio medical waste treatment facility or an
authorized waste treatment facility.
The new Rules have omitted incinerator as one of the pre requisites for on-site
treatment of BMW. The omission is owing to the various environmental impacts of
incineration.
Promotion of new technologies for treatment and disposal of waste
Deep burial for disposal of BMW has also been removed from the Rules. The Rules
says it can be an option only in rural areas with no access to CTF with prior approval
from the prescribed authority.
12. Biomedical waste Statistics
• Developed Countries-Developed Countries- 1-5 kg/bed/day, with variations
among countries.
In India-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
14. DEFINITIONSDEFINITIONS
• Acc to bio medical waste rules ,1998 of India
“ 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 or testing of bio
medicals.
15. Hospital waste: refers to all waste, biological
or non biological, that is discarded and is not
intended for further use.
Medical waste: refers to materials generated
as a result of patient diagnoses, treatment,
immunization of human beings or animals.
16. Infectious waste: are the portion of medical
waste that could transmit an ‘infectious
disease’.
Pathological waste : waste removed during
surgery/ autopsy or other medical procedures
including human tissues, organs, body parts,
body fluids and specimens along their
containers.
17. • Health care Waste: means all the waste generated by
Hospital establishments, research facilities, and
laboratories. In addition, it includes the waste
originating from "minor" or scattered sources such as
that produced in the course of health care undertaken
in the home (dialysis, insulin injections, etc.)
• [Pruss, A., Giroult, E., and Rushbrook P. et. al; "
Safe Management of Wastes from Health-Care
activities", World Health Organisation, , Geneva,
1999. ]
19. Sewage
• Waste water from a community containing
solid and liquid excreta , derived from houses ,
streets and factories.
Sullage
• Waste water which does not contain human
excreta .
21. Classification of health care wastes
Waste categoryWaste category
Infectious wasteInfectious waste
Pathological wastePathological waste
Description And ExamplesDescription And Examples
• Lab culturesLab cultures
• Waste from isolation wardsWaste from isolation wards
• Tissues(swabs)Tissues(swabs)
• Materials/equipments of infectedMaterials/equipments of infected
patientspatients
• ExcretaExcreta
• Human tissues/fluidsHuman tissues/fluids
• Body partsBody parts
• Blood or body fluidsBlood or body fluids
32. • Waste management is the collection ,transport,
processing ,recycling or disposal of waste materials.
• Term usually relates to materials produced by human
activity and is generally undertaken to reduce effect
on health, the environment and aesthetics.
34. The 5 R’s of Waste Management
Refuse – Do not use non bio-degradable materials is the process
in the first place
Eg. No Plastic bags as packaging for consumer products.
Reduce – don’t manufacture goods that will be discarded in the
first place.
Eg. Reduced packaging for consumer products.
Re-use – use materials over again for the original intended
purpose or for a new purpose.
Eg. Plastic grocery bags can be reused for groceries or
you can use them as a lunch bag or something else.
35. Recycle – break down materials and reform them into
new products. Requires much less energy than
manufacturing products from raw materials.
Eg. Pop cans. Aluminum is melted down and
made into new pop cans, storm doors,etc.
Recover – recover as much energy as possible before a
material is discarded.
Eg. Some places will burn garbage, then use the
heat to generate electricity before disposing of the
ash.
38. Dumping
• Easy method of disposal of “dry refuse”
• Dumped in low lying areas
• Decomposes: bacterial action, decreased in
volume & converted to humus.
40. Dumping
Disadvantages
Refuse exposed to flies & rodents
Source of nuisance (smell & unsightly appearance)
Loose refuse dispersed by the action of wind
Pollution of surface & ground water.
41. Controlled tipping (or) Sanitary land fill
• Method:
• Material placed in trench
• Adequately compacted
• Covered with earth at the end of the day
• “Modified sanitary land fill”
- Compaction & covering once or twice a week
42. Controlled tipping
• Three methods used:
1. Trench method: 2-3 meter deep trench dug out 4 -12 meter
wide. Refuse upto a depth of 2meters - 1 acre of land /yr for
10000 popln
2. The ramp method: used in sloping terrain
3. The area method: used for filling land depressions, disused
quarries & clay pits
43. Controlled tipping
• Changes in the buried refuse:
Physical, chemical & bacteriological changes
During decomposition temp rises to 60 deg
In 7 days. Kills all the pathogens
2 – 3 weeks to cool down
4-6 months for decomposition
44. Incineration
• Burning the refuse
• More hygienic
• Hospital refuse
• Disadv: production of harmful gases &
chemicals (carcinogenic)
• Used: where suitable land is not available
• Not suitable in India
45. Composting
Composting is a method of combined disposal of
refuse and nightsoil or sludge.
Process of nature whereby organic matter breaks
down under bacterial action resulting in the relatively
stable humus like material called compost.
46. Composting
• Principle by products are:
Carbon dioxide, water & heat.
Heat produced is 60 deg
Destroys eggs & larvae of flies, weed seeds &
pathogenic agents.
The end product - compost - contains few or no
disease producing micro organisms, contains plant
nutrients - nitrates & phosphates
48. Composting
1. Bangalore method:
Indian council of Agricultural research at Indian
institute of Science, Bangalore.
Anaerobic compositing
Trenches are:
• 3 feet deep, 5-8 feet broad, 15-30 feet long
• Located ½ mile away from the city limits
49. Composting
Bangalore method:
• Method:
• First a layer of refuse about 6 inches thick
• Over this night soil is added 2 inch thick
• Alternate layers of night soil & refuse added
• Till the heap rises to 1 feet above the ground level.
• Top layer - refuse at least 9 inches thickness.
• Heap covered with excavated earth.
50. Composting
Bangalore method:
• Within 7 days heat generated
• Heat persists for 2 or 3 weeks
• Destroy all pathogenic & parasitic organisms
• End of 4-6 months decomposition is complete
• Manure: well decomposed, odourless, innocuous
material, high manurial value, ready for application
to the land.
51. Composting
2. Mechanical composting:
• Aerobic method
Method:
• Refuse first cleared of salvable material
• Then pulverized in the pulverizing equipment
• Reduce the particle size to 2 inches
• Mixed with sewage, sludge or night soil in rotating
machine & incubated
• 4-6 weeks composting completed.
52. Manure pits
• Rural areas
• Garbage, cattle dung, straw & leaves
• Covered with earth after each days dumping
• 2 pits required
• 5-6 months time refuse converted to manure
• Effective and simple.
53. Burial
• Suitable for small camps
• Trench:
• 1.5m wide , 2 meters deep
• At the end of the day refuse is covered with 20-30cms
of earth
• 40cms from ground level, new trench is dug out.
• Contents removed after 4 -6 months
54. Sanitation barrier
Concept found wide acceptance.
Diseases due to insanitary conditions can be
prevented by blocking the channels/modes of
transmission namely the 5 F’s.
Segregate the faeces & arrange for its proper
disposal
water
Fingers
Flies
Soil
Food
Protected
host
Faeces
Sanitationbarrier
water
Fingers
Flies
Soil
Food
Protected
host
Faeces
Sanitationbarrier
55. Sanitation barrier
Simple terms:
• Sanitary latrine & a Disposal pit
More elaborate schemes: Installation of a
sewerage system & Sewage treatment plans
56.
57. Water Carriage System
Duct system
Excrements are safely disposed off by carrying those
along with water.
Sewage = 99.9% water & only 0.1% solids
Sanitary sewage : waste water from residences and
industries and is also called DRY WEATHER FLOW
(D.W.F).
Combined system of sewerages allows rainwater
during monsoons.
58. Water Carriage System
These are all carried through underground
sewerages.
The amount of sewage produced per person is
directly related to the water supplied per capita
and ranges from 1.15 litres per day in small
towns to 180 litres per day in large cities.
59. WARNING!!!
Sewage gas is a mixture of gases in sewers
and manholes comprising of CO2,methane,
hydrogen sulphide and a little oxygen.
This is generated by putrefying bacteria and is
combustible.
This is an important information should be
kept in mind before anybody attempts to go
into a manhole or a septic tank for repair
works.
60. Sea outfall
• Sea coast town and cities
• Nearly two-third of sewage of greater mumbai
• Purification by dilution and oxidation
• Drawback: offensive solid waste back to coast.
• Sewage outfall designed to discharge it deep into the
sea at many points.
63. S.N
O
WASTE
CATEGORY
WASTE TYPE TREATMENT
& DISPOSAL
1 Category No.1 Human Anatomical waste (human tissues,
organs, body parts
Incineration/deep
burial
2 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,
colleges, discharge from hospitals, animal
houses
Incineration/deep
burial
3 Category No.3 Microbiology & Biotechnology Wastes:
Wastes from laboratory cultures, stocks of
specimens of micro-organisms live or
attenuated vaccines etc.
Autoclave/
Microwave/
Incineration
4 Category No.4 Waste Sharps (needles, syringes, scalpels
,blades, glass etc.) that may cause puncture
and cuts.
Disinfection
(chemical
treatment/autoclavE/
microwavE and
mutilation/shredding
CATEGORIES OF BIO-MEDICAL WASTE
64. S.No WASTE
CATEGORY
WASTE TYPE TREATMENT
AND DISPOSAL
5 Category No.5 Discarded Medicines and Cytotoxic
drugs Wastes comprising of outdated,
contaminated and discarded medicines
Incineration/destruction
and drugs disposal in
secured landfills
6 Category No.6 Soiled Waste (Items contaminated with
blood, and body fluids including cotton,
dressings, soiled plaster casts, linens,
beddings, other material contaminated
with blood)
Incineration
autoclaving/
microwaving
7 Category No.7 Solid Waste (waste generated from
disposable items other than the waste
(sharps) such as tubing's, catheters,
intravenous sets etc.
Disinfection by chemical
treatment/autoclaving/
Microwaving &
mutilation/shredding
8 Category No.8 Liquid Waste generated from laboratory
and washing, cleaning, house keeping and
disinfecting activities
Disinfection by chemical
treatment and
discharge into drains
65. S.No WASTE
CATEGORY
WASTE TYPE TREATMENT AND
DISPOSAL
9 Category No.9 Incineration Ash: Ash from
incineration of any bio-medical
waste
Disposal in municipal landfill
10 Category No.10 Chemical Waste
Chemicals used in production of
biologicals, chemicals used in
disinfection as insecticides etc.
Chemical treatment and
discharge
into drains for liquids and
secured landfill for solids
NOTE :
1. Chemicals treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent.
2. Mutilation/shredding must be such so as to prevent unauthorized reuse.
3. There will be no chemical pretreatment before incineration. Chlorinated plastics should not be
incinerated.
4. Deep burial shall be an option available only in towns with population less than five lakhs and in rural
area.
66. COLOUR CODING AND TYPE OF CONTAINER FOR
DISPOSAL OF BIOMEDICAL WASTE
ColorColor
CodingCoding
Type ofType of
ContainerContainer
WasteWaste
CategoryCategory
TreatmentTreatment
options as peroptions as per
Schedule ISchedule I
YellowYellow Plastic bagPlastic bag Cat.1, 2,3,6Cat.1, 2,3,6 Incineration/deepIncineration/deep
burialburial
RedRed DisinfectedDisinfected
container/Plasticontainer/Plasti
c bagc bag
Cat 3,6,7Cat 3,6,7 Autoclave/Microwave/Autoclave/Microwave/
Chemical TreatmentChemical Treatment
Blue/WhiteBlue/White
translucenttranslucent
Puncture proofPuncture proof
containercontainer
Cat.4,7Cat.4,7 Autoclave/Microwave/Autoclave/Microwave/
Chemical Treatment &Chemical Treatment &
destruction/shreddingdestruction/shredding
BlackBlack Plastic bagPlastic bag Cat 5,9,10Cat 5,9,10 Disposal in securedDisposal in secured
landfilllandfill
67.
68. Segregation and Collection
Safe transportation and Storage
Treatment & Disposal of BMW
To ensure clean & healthy environment:
69.
70. Use of plastic bags makes the transportation easier, it prevents the spillage and the
waste remains outside the view of others. This also keeps the original containers
clean. The plastic bags are not to be reused.
When bag or container, as the case may be, is three fourth full, it should be sealed
by tying it. The disposable sharps container should be sealed by tape. All bags or
containers must be labeled which shall be non washable/prominently visible
72. TRANSPORT TO THE CENTRAL STORAGE AREA
While transporting the waste to the central storage area certain rules
must be followed:
1. Check that waste bags/containers are properly and effectively sealed.
2. Waste bag is properly labeled.
3. Bags should be picked up by the neck and placed, so that bags can be
picked up by the neck again for further handling. Hand should not be put
under the bag. At a time only one bag should be lifted.
73. 4. Manual handling of waste bags should be minimized to reduce the risk of
needle prick injury and infection. Avoid close contact between body and bag
container.
5. Waste bag or container should not be thrown or dropped.
6.After removal of the bag, clean the container including lid with an appropriate
disinfectant.
7.Bags or containers containing the waste should be transported in covered
wheeled containers or large bins in covered trolleys dedicated for this purpose.
The bags and containers should be replaced by fresh bag/container .
Bio- medical waste storage areas must be separate from general waste storage
sites and should have clear signs indicating "For Biomedical Waste only".
74. 8. In case, a lift is to be used during transportation of biomedical
waste it should be designed and reserved for this purpose only.
75. To reduce the impact on the community
To reduce the chances of infection and accidental injury to
the workers
To support conservation of natural resources and preservation
of environmental quality.
To reduce the cost and handling time
76. CENTRAL STORAGE
The central storage area should be ideally situated on the ground floor and
near the rear entrance. This will make the transportation of waste to the site of
final disposal easier.
The central storage area should be big enough to store the required number of
waste bags at a time. There should be sufficient storage capacity to store at least
two day's waste.
It should have a good flooring, light, ventilation and water supply. There
should be special drain to discharge the washing, which should go to the sewer.
A full time storekeeper should be responsible to receive and dispatch the
waste and maintain proper records.
77. Unauthorized people should not be
able to enter the storage area.
An accidental spillage should be
properly attended.
As per rules, biomedical waste cannot
be stored for more than 24 to 48 hours.
Refrigerated storage room (cold
rooms) can be considered where wastes
have to be stored in bulk for over 48
hours.
78. TRANSPORT TO THE FINAL DISPOSAL SITE
Transportation from the health care establishment to the site of final disposal
should preferably be done in a motor vehicle, as these sites are likely to be
situated at a distance from the hospital.
Closed transportation in these motor vehicles (truck, tractor, trolley, etc) is
desirable as it prevents the spillage on the way.
All these vehicle must have the biohazard symbol and they should not be used
for any other purpose.
Proper servicing is a must regular basis.
79. Temporary storage of biomedical waste may also be needed at the site of final
disposal. It should have all characteristics similar to that described for the central
storage area of the hospital.
80. To reduce the impact on the community
To reduce the chances of infection and accidental injury to
the workers
To support conservation of natural resources and preservation
of environmental quality.
To reduce the cost and handling time
81. Treatment is a term used for those processes that modify the waste in some
way before it is finally disposed off.
According to the draft Biomedical (Management and Handling) R 1995…..
Treatment means: "a method, technique, or process designed to change the
physical, chemical or biological characteristics or composition of any biomedical
waste so as to render such waste non-hazardous to health and environment".
The primary aim of treatment is to disinfect or decontaminate the waste to
eliminate the pathogens before it reaches the site of its final disposal.
82. Five technology options for treatment
Incineration
Chemical disinfection
Wet and dry thermal treatment
1. Wet thermal treatment
2. Screw-feed technology
Micro wave irradiation
Land disposal
1. Municipal disposal sites
2. Sanitary landfills
Inertization
83. INCINERATION
Incineration is the complete destruction of materials to their inert
constituents by a process of combustion.
Safe way of disposal
There is reduction of volume and weight by approximately--- 95%
84. Types of incinerators:
•Double-chamber pyrolytic incinerators: designed to burn infectious
health-care waste.
•Single-chamber furnaces with static grate, used only if pyrolytic
incinerators are not affordable.
•Rotary kilns operating at high temperatures, capable of causing
decomposition of genotoxic substances and heat-resistant chemicals.
85. Characteristics of the waste suitable for incineration are:
a) Low heating volume-above 2000 Kcal/kg for single-chamber
incinerators, and above 3500 Kcal/kg for pyrolytic double-chamber
incinerators
b) Content of combustible matter above 60%
c) Content of non-combustible solids below 5 %
d) Content of non-combustible fines below 20 %
e) Moisture content below 30%
86.
87. Chemical treatment
Plastic, rubber and metallic items (like IV sets, blood bags, gloves, catheters,
syringes and needles must be chemically disinfected before they are sent for final
disposal (landfill).
Chemical disinfection can be done in following steps:
1. Mutilate the syringes and needles with a needle destroyer.
Cut all other plastic/rubber item with the help of scissors (so that they cannot be
reused),
2. Make 1 per cent hypochlorite solution (fresh everyday) by dissolving 10 gms of
this powder (approx 2 spoonfuls) in 1 litre of water in a plastic bucket.
88. 3. Keep another, smaller bucket with perforations inside the main
bucket (having the solution). Put all the items that are to be
disinfected inside the perforated bucket and keep well- dipped for
about 30-60 minutes.
4. After 30 to 60 minutes take out the disinfected items and put
them in a proper waste bag. Sharps should be first kept in a tough
cardboard box then only put in the plastic bag so as to avoid
damage to the bags.
5. Change the solution every 12 hours.
Commonly used – Sodium hypochlorite solution, Cresol, Savlon,
Bleaching powder
89.
90. Wet and dry thermal treatment
Wet thermal treatment:
•Based on exposure of shredded infectious waste to high temperature, high pressure steam.
•Similar to the autoclave sterilization process.
•Inappropriate for the treatment of anatomical waste and animal carcasses.
•Will not efficiently treat chemical and pharmaceutical waste.
Screw-feed technology
•Screw-feed technology is the basis of a non-burn, dry, thermal disinfection process in which
waste is shredded and heated in a rotating auger.
•The waste is reduced by 80 % in volume and by 20-35 % in weight.
•Suitable for treating infectious waste and sharps.
•Should not be used to process pathological, cytotoxic or radioactive waste.
91. Microwave irradiation
•Most microorganisms are destroyed by the action of microwave of a frequency of
about 2450 MHZ and a wavelength of 12.24 cm.
•The water contained within the waste is rapidly heated by the microwave and the
infectious components are destroyed by heat conduction.
• The efficiency should be checked routinely through bacteriological and virological
tests
STANDARDS OF MICROWAVE
•Not be used for cytotoxic, hazardous,/radioactive wastes, contaminated animal
carcasses, body parts, & large metal items.
92. Disposal means placing the biomedical waste in its final resting
place
According to the draft Biomedical Waste (Management and
Handling) Rules, 1995.
Disposal means : "burial, discharge, deposit, dumping, land filling or
placing on land of any biomedical waste".
93. Two types of disposal:- 1) Land open dumps.
2) Sanitary landfills.
Health-care waste should not be deposited on or around open dumps.
Advantages of sanitary landfill over open dumps:
Geological isolation
Appropriate engineering preparation of the site.
Staff present on site to control operations,
Organized deposit and daily coverage of waste.
94. Sanitary landfills
It is another choice for final disposal of biomedical waste and it can be quite
effective if practiced appropriately.
While open dumping of biomedical waste cannot be recommended for the reasons of
acute pollution problems, fires, higher risk of disease transmission and open access to
scavengers and animals.
Some essential elements for design and operation of a sanitary landfill are given below:
1. A specifically designated place should only be used for the landfill.
95. 2. The site should preferably be away from the residential areas.
3. Location should be such that vehicles carrying waste can easily
approach it in all weathers.
4. The area should be under constant supervision and security control.
Unauthorized entry must be strictly prohibited.
5. It should not be in the vicinity of a drinking water source as pollution
may result.
6. The site should be divided into various manageable phases and all of
them should be adequately prepared before the actual and fill starts.
96. 7. The site should be so organized that the waste can be spread, compacted and covered
daily.
8. A final cover should be constructed to prevent the rain water infiltration when each
phase of landfill is completed. A temporary cover should be provided if rains are
expected in between and before the site is completed.
9. Waste should be buried as rapidly as possible so as to minimize the exposure to
humans or animals.
97. Inertization
•The process of “Inertization” involves mixing waste with cement and
other substances before disposal.
proportion of the mixture :
•65% pharmaceutical waste, 15 % lime, 15% cement and 5 % water.
98. The purpose of treatment of biomedical waste
To reduce or eliminate pathogens so that they no longer pose a hazard to
persons exposed to it
It changes the physical appearance of waste to make it unrecognizable so
that it is not aesthetically offensive or frightening.
It also reduces the bulk volume of waste to reduce requirements for
storage and transport.
It makes recyclable items unusable so that unauthorized reuse is
prevented.
To reduce the cost and handling time
99.
100. Statewise status of common Biomedical waste
management facilities
(As per the informationprovided by the
SPCBs/PCCs for the year 2008)
101.
102. • There are a number of wastes typically generated by a dental office which,
if improperly handled may pose a risk to human health and the
environment. These are:
Mercury and silver residues from amalgam
Lead found in lead-foil packets and lead shields
Silver found in X-ray fixer solutions
Chromium, used in many X-ray cleaners
Chemical wastes, such as formaldehyde, acetones, and ketones
103. ADA Best Management Practices
for Amalgam Waste
• Do’s :
1. Do use precapsulated alloys and stock a variety of capsule sizes
2. Do recycle used disposable amalgam capsules
3. Do salvage, store and recycle non-contact amalgam (scrap amalgam)
4.Do salvage (contact) amalgam pieces from restorations after removal and recycle the
amalgam waste
5. Do use chair-side traps, vacuum pump filters and amalgam separators to retain amalgam and
recycle their contents.
6. Do recycle teeth that contain amalgam restorations.
7. Do manage amalgam waste through recycling as much as possible
(Note: Ask your recycler whether or not extracted teeth with amalgam restorations require
disinfection.)
104. ADA Best Management Practices
for Amalgam Waste
• Don’ts
1. Don’t use bulk mercury
2. Don’t put used disposable amalgam capsules in biohazard containers, infectious waste
containers (red bags) or regular garbage.
3. Don’t put non-contact amalgam waste in biohazard containers, infectious waste containers (red
bags) or regular garbage
4. Don’t put contact amalgam waste in biohazard containers, infectious waste containers (red
bags) or regular garbage
5. Don’t rinse devices containing amalgam over drains or sinks
6. Don’t dispose of extracted teeth that contain amalgam restorations in biohazard containers,
infectious waste containers (red bags), sharps container or regular garbage
7. Don’t flush amalgam waste down the drain or toilet
105. Never dispose of scrap amalgam in the sharps
container, red biohazard bag or the trash.
106. SHARPS
• Sharps waste is in the form of medical waste in
the form of devices or objects used to puncture
or lacerate the skin.
• Sharps waste is designated as biohazard and is
to be carefully handled.
107. SHARPS
Contaminated sharps are capable of transmitting the disease
from injection needles, orthodontic bands,burs, scalpel blades,
sutures, instruments and broken glass.
Sterilization of sharp containers
• Use labeled and specified container
• Spore test the sterilizer.
• Label the disposable containers as to local regulations.
• Keep containers in upright position.
• Process containers for 40- 60 minutes.
• Leave containers vent open.
110. Handling of Sharps
• Needles should not be bend, break, or
manipulated for the avoidance of accidents in
clinic
• Protective cap holdings devices capping sheath
by scoop technique
• Size of sharp container also influence overall
efficacy of sterilization
111. X-RAY FIXER AND DEVELOPER
• Separate fixer and developer solutions in the
container provided by the approved waste
carrier and supplier.
• Label the container.
• Once the container is full contact appropriate
waste carrier for disposal.
112. CONTAMINATED LAUNDRY
• Contaminated laundry is to be placed and transported
in bags containers that are color coded or labeled with
a biohazard symbol.
• If the contaminated laundry is sent off site for
cleaning, it must be placed in bags or containers that
are color coded or labeled with a biohazard symbol,
unless the laundry uses universal precautions in
handling all soiled laundry.
114. • Safe and effective management of bio-
medical waste is not only a legal
necessity but also a Social
Responsibility.
115. • Bio-Medical Waste Management cannot
successfully be implemented without the
willingness, devotion, self-motivation,
cooperation and participation of all
sections of employees of any health care
establishment.
116. • If we want to protect our environment
and health of the community we must see
ourselves to this important issue not only
in the interest of health managers but also
in the interest of community.
117. REFERENCES
• Textbook of preventive and social medicines –
Park- Ed 21
• Text of essential of preventive and community
dentistry – Soben Peter – Ed 5
• “Infection Control & Management of
Hazardous Materials for Dental Team” Chris
H.Miller,Charles John Palenik.