This document discusses guidelines for biomedical waste management according to the BMW rules of 1998, 2011, and 2016 in India. It defines biomedical waste and outlines the objectives of proper waste management. It describes the classification of waste into categories based on risk level and provides guidelines for segregation, treatment, and disposal of each waste category according to the color-coding system. The risks of improper waste management to health and the environment are also discussed.

1. BIOMEDICAL WASTE MANAGEMENT
Dr. Hemali Parmar
MBBS, MD (Microbiology)
Tutor Microbiology
Medical College, Vadodara

2. OBJECTIVES
 Various BMW rules (1998, 2011, 2016)
 Classification of biomedical waste (various
waste categories)
 Segregation of waste (colour coding system
for waste disposal)
 Pre treatment & decontamination
 Final disposal
2

3. INTRODUCTION OF WASTE MANAGEMENT
 Hospital waste is a potential reservoir of
pathogenic micro-organisms.
 Decontamination of waste and their ultimate
disposal are closely interrelated.
 Laboratory wastes are of different category.
3

4. DEFINITION
 “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, including the categories mentioned in
Schedule-I appended to these rules;
4

5. APPLICATION
 These rules shall apply to all persons who generate,
collect, receive, store, transport, treat, dispose, or handle
bio medical waste in any form including
 Hospitals, nursing homes, clinics,
 Dispensaries, veterinary institutions, animal houses, slaughter
house
 Pathological laboratories, blood banks,
 Ayush hospitals, clinical establishments,
 Research or educational institutions,
 Health camps, medical or surgical camps, vaccination camps,
blood donation camps,
 First aid rooms of schools,
 Forensic laboratories and research labs.
 Mortuaries/autopsy centers
5

6. THESE RULES SHALL NOT APPLY TO
 (a) radioactive wastes as covered under the provisions of the Atomic Energy
Act, 1962(33 of 1962) and the rules made there under;
 (b) hazardous chemicals covered under the Manufacture, Storage and
Import of Hazardous Chemicals Rules, 1989 made under the Act;
 (c) solid wastes covered under the Municipal Solid Waste (Management and
Handling) Rules, 2000 made under the Act;
 (d) the lead acid batteries covered under the Batteries (Management and
Handling) Rules, 2001 made under the Act;
 (e) hazardous wastes covered under the Hazardous Wastes (Management,
Handling and Transboundary Movement) Rules, 2008 made under the Act;
 (f) waste covered under the e-Waste (Management and Handling) Rules, 2011
made under the Act; and
 (g) hazardous micro organisms, genetically engineered micro
organisms and cells covered under the Manufacture, Use, Import, Export and
Storage of Hazardous Microorganisms, Genetically Engineered Micro organisms
or Cells Rules, 1989 made under the Act.
6

7. PEOPLE AT RISK
 Doctors, Nurses & hospital staff
 Patients & visitors of hospital
 Veterinary staff
 Health workers
 Laboratory staff
 Research staff
 Slaughter house persons
 Servants handling BMW
 Disposal facility staff
 Animal handling persons
7

8. HEALTH HAZARDS ASSOCIATED WITH
POOR MANAGEMENT OF BMW
 Injury from sharps
 Hospital acquired infections
 Risk of infection outside the hospital for waste
handlers/scavengers & eventually general public
 Occupational risk associated with hazardous
chemicals, drugs etc.
 Unauthorized repackaging & sale of disposable
items & unused/expired drugs
8

9. ENVIRONMENT CONCERN
 Spread of infection and disease through vectors (fly,
mosquito, insects etc.) which affect the in -house as well
as surrounding population.
 Spread of infection through contact/injury among
medical/non-medical personnel and sweepers/rag
pickers, especially from the sharps (needles, blades etc.).
 Spread of infection through unauthorised recycling of
disposable items such as hypodermic needles, tubes,
blades, bottles etc.
 Reaction due to use of discarded medicines.
 Toxic emissions from defective/inefficient incinerators.
 Indiscriminate disposal of incinerator ash / residues
9

10. 10

11. PROBLEMS RELATING TO BIOMEDICAL WASTE
 The implementation of Bio-Waste regulation is
unsatisfactory as some hospitals are disposing of waste
in a haphazard, improper and indiscriminate manner.
 Lack of motivation for proper BMW management.
 Lack of segregation practices, results in mixing of hospital
wastes with general waste making the whole waste
stream hazardous.
 Inappropriate segregation ultimately results in an incorrect
method of waste disposal.
 Inadequate Bio-Medical waste management -------
environmental pollution, unpleasant smell, growth and
multiplication of vectors like insects, rodents and worms.
11

12. BENEFITS OF BIOMEDICAL WASTE MANAGEMENT
 Cleaner and healthier surroundings.
 Reduction in the incidence of hospital acquired and
general infections.
 Reduction in the cost of infection control within the
hospital.
 Reduction in the possibility of disease and death due to
reuse and repackaging of infectious disposables.
 Low incidence of community and occupational health
hazards.
 Reduction in the cost of waste management and
generation of revenue through appropriate treatment and
disposal of waste.
 Improved image of the healthcare establishment and
increase the quality of life.
12

13. 13

14. GENERATION OF WASTE
Types Site of Generation Disposal by
Non hazardous
(general waste 85%)
Office, kitchen, cafeteria billing, cashier,
rooms, hostels, residential area, rest
room, pantries in Wards, stores.
In black / green bag-
Municipal waste
Hazardous
(infectious & toxic 15%):-
-Hazardous but not
infectious- 5%
-Hazardous and
infectious- 10%
Wards, treatment room, nursing station,
isolation room, operation theaters,
intensive care unis & recovery room,
labour room & clinics, dental suites, minor
OT, blood bank, pharmacy & medical
stores, laboratories, animal house,
experimental centers, OPD treatment
room, injection & procedures rooms
As per biomedical
waste management
Rule 2016.
14

15.  As per WHO, the biomedical wastes could be classified
into eight categories on the basis of the type of waste
and the risk of transmission of infectious material in
them.
1. General waste (domestic)
2. Pathological
3. Radioactive
4. Chemical
5. Infectious
6. Pharmaceutical wastes
7. Sharps and
8. Pressurized containers
15

16. NOTIFICATION & AMENDANTMENT
 On 20th July 1998, Ministry of Environment &
forests, Govt. of India, formed a rule known
as Biomedical waste management and
handling rule 1998.
 1st amendment dated on 06/03/2000
 2nd amendment dated on 17/09/2003
 BMW 2011 rule
 BMW 2016 rule
16

17. CLASSIFICATION OF WASTE
 To streamline over all handling of hospital waste, it has
been classified into several categories.
 Each laboratory should have a working estimate of non-
hazardous and hazardous waste produced there on day-
to-day basis.
 The waste segregation with an ultimate aim of safe
handling and disposal has been classified into various
categories.
 They have been given colour coding for collection i.e. in a
specified container only a specified type of waste should
be collected.
 Segregation at the point of generation of waste must be in
accordance with this colour coding.
 Categories waste segregation and collection is a
mandatory legal requirement.
17

18. BMW RULES, 1998
Category no. Waste category Disposal
1 Human Anatomical Waste Incineration@@
2 Animal waste Incineration@@
3
Microbiology & Biotechnology
waste and other laboratory
waste
Disinfection at source by chemical treatment@ or by autoclaving/microwaving followed
by mutilation/shredding## and after treatment final disposal in secured landfill or disposal of recyclable
wastes (plastic or glass) through registered or authorized recyclers
4 Waste sharps
Disinfection by chemical treatment@ or destructionby needle and tip cutters, autoclaving or
microwaving followed by mutilation or shredding##, whichever is applicable and final disposal through authorized
CBWTF or disposal in secured landfill or designated concrete waste sharp pit
5
Discarded medicines and
cytotoxic drugs
Secure landfill or incineration@@
6 Soiled waste Incineration@@
7 Infectious solid waste
Disinfection by chemical treatment@ or autoclaving or microwaving
followed by mutilation or shredding## and after treatment final disposal through
registered or authorized recyclers
8 Liquid waste Chemical treatment@ and discharge into drains
9 Incineration Ash disposal in municipal landfill
10 Chemical waste
Chemical treatment@ and discharge into drains meeting the norms notified
under these rules and solid disposal in secured landfill
18

19. BMW RULES, 1998
19

20. CONT…
 There is lots of confusion about category &
color coding, few categories can be
discarded in more than 1 bag, no special
description of waste etc.
 The table in next slides comes as product of
schedule I of Rule 4 and 7 of Bio-medical
waste (Management and handling) Rules
2011.
20

21. CONT…
Category
no.
Waste category Disposal
1
Human Anatomical Waste
(human tissues, organs, body parts)
Incineration@@
2
Animal waste
(animal tissue, organs, body parts, carcasses,
bleeding parts, fluid, blood and experimental
animals used in research, waste generated by
veterinary hospitals/ colleges, discharge from
hospitals, animal house)
Incineration@@
21

22. Category
no.
Waste category Disposal
3
Microbiology & Biotechnology waste
and other laboratory waste
(wastes from clinical samples, pathology,
biochemistry, haematology, blood bank,
laboratory cultures, stock or specimen of
microorganisms, live or attenuated
vaccines, human and animal cell culture
used in research and infectious agents
from research and industrial laboratories,
waste from production of biological
toxins, dishes and devices used for
transfer of cultures)
Disinfection at source by
chemical treatment@ or by
autoclaving/microwaving
followed by
mutilation/shredding## and
after treatment final disposal
in secured landfill or disposal
of recyclable wastes (plastic
or glass) through registered
or authorized recyclers
22

23. CONT…
Category
no.
Waste category Disposal
4
Waste sharps
(needles, glass syringes or syringes with
fixed needles, scalpels, blades, glass etc.
that may cause puncture and cuts. This
includes both used and unused sharps)
Disinfection by chemical treatment@
or destruction by needle and tip
cutters, autoclaving or microwaving
followed by mutilation or shredding##,
whichever is applicable and final
disposal through authorized CBWTF
or disposal in secured landfill or
designated concrete waste sharp pit
5
Discarded medicines and cytotoxic
drugs
(wastes comprising of outdated,
contaminated and discarded medicines)
Disposal in secure landfill or
incineration@@
23

24. CONT…
Category
no.
Waste category Disposal
6
Soiled waste
(Items contaminated with blood, and body
fluids including cotton, dressings, soiled
plaster casts, linen, beddings, other material
contaminated with blood)
Incineration@@
7
Infectious solid waste
(Wastes generated from disposable items
other than the waste sharps such as tubings,
hand gloves, saline bottles with IV tubes,
catheters, glass, intravenous sets etc.)
Disinfection by chemical
treatment@ or autoclaving or
microwaving followed by
mutilation or shredding## and after
treatment final disposal through
registered or authorized recyclers
24

25. CONT…
Category
no.
Waste category Disposal
8
Chemical waste
(Chemical used in production of
biologicals,
chemicals used in disinfection, as
insecticides, etc.)
Chemical treatment@ and
discharge into drains meeting
the norms notified under
these rules and solid disposal
in secured landfill
25

26. SEGREGATION OF WASTE
 Colour coding and type of container for disposal of bio
medical wastes:
Colour
Coding
Type of container to
be used
Waste category number
Old
category
number
Treatment
options as per
schedule I
Yellow
Non-chlorinated plastic
bags
Category 1,2,5,6 1,2,3,6 Incineration
Red
Non-chlorinated plastic
bags/puncture proof
container for sharps
Category 3,4,7
(4-waste sharps) (in the
earlier Rules, soiled waste
are for red colour)
3,6,7
As per schedule I
(Rule 7)
Blue
Non-chlorinated plastic
bags container
Category 8 (chemical
waste)
4,7
As per schedule I
(Rule 7)
Black
Non-chlorinated plastic
bags
Municipal waste 5,9,10
Disposal in
Municipal dump
sites 26

27. LATEST RULE
 GOVERNMENT OF INDIA
MINISTRY OF ENVIRONMENT, FOREST
AND CLIMATE CHANGE, 28th March, 2016
 Biomedical wastes categories and their
segregation, collection, treatment,
processing and disposal options
27

28. BMW 2016 RULE
 Schedules: 1-4
 Forms: 1-5
 Rules:1-18
28

29. 29

30. 30

31. OCCUPIER ,OPERATOR
 Occupier- a person having administrative control over
the institution and the premises, generating
biomedical waste.
 Operator of common biomedical waste treatment
facility- a person who owns or controls a common
Biomedical Waste Treatment facility (CBMWTF) for
collection, reception, storage, transport, treatment,
disposal or any other form of handling of biomedical
waste.
 The occupier or operator of common biomedical
waste treatment facility shall be liable for action under
section 5 & section 15 of the Act, in case of any
violation.
31

32. DUTIES OF OCCUPIER
 Take necessary steps to ensure BMW is handled
without adverse effect to human health &
environment
 Make provision for central collection zone of
segregated waste within the premises acc. to color
code, provide safe, ventilated and secured location
for storage.
 On site pretreatment of the laboratory waste,
microbiological waste, blood samples, blood bags
through disinfection or sterilization acc.to
WHO/NACO guideline then sent to final disposal
 Phase out use of chlorinated plastic bags, gloves
and blood bags within 2 years from the date of
notification of these rules.-
32

33. CONTD…
 Dispose solid waste other than BMW acc. to municipal waste law
 Do not give treated biomedical waste with municipal waste
 Provide training to all staff regarding handling of the BMW and
refresher training every year
 Immunize all healthcare workers & others handling BMW
especially hepatitis B & Tetanus acc. to national immunization
guideline
 Establish Bar-Code System for bags or containers containing
BMW to be sent out of the premises within 1 year of notification of
the rule
 Provide adequate PPE
 Ensure segregation of liquid chemical waste at source and
ensure pretreatment or neutralization prior to mixing with other
effluent generated from health care facilities.( Effluent drainage
system)
 Conduct health check up at the time of induction and least once
in year 33

34. CONTD…
 Monthly record on websites according to the biomedical waste
generated in terms of category and color coding .
 Report major accidents including accidents caused by fire
hazards, blast during handling of BMW & remedial action taken
and relevant records in form-I to prescribed authority and also
along with annual report.
 Make available annual report on its web site and all healthcare
facilities shall make own website within 2 years from the date of
notification of these rules.
 Establish system to review & monitor the activities regarding
BMW through committee-meets every six month & record MOM
submitted along with annual report to prescribed authority.
 Maintain all records of incineration /autoclaving for minimum 5
years.
 Existing incineration meets standard for treatment & disposal of
BMW.(Dioxin and furans)
34

35. 35

36. 36

37. BIO-WASTE TREATMENT AND DISPOSAL-
OPERATOR RESPONSIBILITY
 No occupier shall establish on site treatment & disposal
facility, if a service of common biomedical waste
treatment facility (CBMWTF) is available at a distance of
75 km.
 In cases where BMW treatment facility is not available,
occupier shall set up requisite equipments like
incineration, autoclave, shredder prior to commencement
of its operation as per authorization given by prescribed
authority.
 After treatment, the recyclable waste such as plastic &
glassware shall be given to such recyclers having valid
authorization or registration from respective prescribed
authority.
 Also maintain records
37

38. STEPS TO MANAGE BIOMEDICAL WASTE
 Segregation – at point of generation
 Transportation – within hospital premises, and
from central storage to the point of final
treatment
 Pretreatment – for microbiolgical waste, blood
bags, blood samples, vaccines
 Storage
 Final treatment
 Documentation
38

39. SEGREGATION, TRANSPORT, STORAGE OF
WASTE
 Segregation is carried out at the point of
generation to keep general waste from
becoming infectious
 Segregation is according to color coding
system and BMW rule 2016
39

40. BIO-MEDICAL WASTE MANAGEMENT RULES, 2016
Category Type of waste Type of bag or
container to be
used
Treatment & disposal options
Yellow Human anatomical waste (Human
tissues, organs, body parts and fetus
below the viability period)
Yellow coloured non-
chlorinated plastic bags
Incineration or plasma pyrolysis or deep
burial* (only in rural & remote areas)
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.)
Soiled waste (Items contaminated
with blood, body fluids like dressings,
plaster casts, cotton swabs and bags
containing residual or discarded blood
and blood components.)
Incineration or plasma pyrolysis or deep
burial*. Autoclaving or
microwaving/hydroclaving followed by
shredding or mutilation . Sent for energy
recovery
40

41. BIO-MEDICAL WASTE MANAGEMENT RULES, 2016
Category Type of waste Type of bag or
container to be
used
Treatment & disposal options
Yellow 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
Expired `cytotoxic drugs and items
contaminated with cytotoxic drugs to be
returned back to the manufacturer or
supplier for incineration at temperature
>1200°C or to common bio-medical
waste treatment facility or hazardous
waste treatment, storage and disposal
facility for incineration at >1200°C or
Encapsulation or Plasma Pyrolysis at
>1200°C.
All other discarded medicines shall be
either sent back to manufacturer or
disposed by incineration.
Chemical waste (Chemicals used in
production of biological and used or discarded
disinfectants.)
Yellow coloured non-
chlorinated plastic bags
Incineration or plasma pyrolysis or
encapsulation
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
After resource recovery, the chemical
liquid waste shall be pre-treated before
mixing with other wastewater. The
combined discharge shall conform to
the discharge norms given in Schedule-
III.
41

42. BIO-MEDICAL WASTE MANAGEMENT RULES, 2016
Category Type of waste Type of bag or container
to be used
Treatment & disposal
options
Yellow Discarded linen, mattresses, beddings
contaminated with blood or body fluid.
Yellow coloured non-chlorinated
plastic bags or suitable packing
material
Non- chlorinated chemical
disinfection followed by incineration
or Plazma Pyrolysis or for energy
recovery.
In absence of above facilities,
shredding or mutilation or
combination of sterilization and
shredding. Treated waste to be sent
for energy recovery or incineration or
Plazma Pyrolysis.
Microbiology, biotechnology &
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
Pre-treat to sterilize with
nonchlorinated chemicals on-site as
per National AIDS Control
Organisation or World Health
Organisation guidelines thereafter for
Incineration.
42

43. Category Type of waste Type of bag or container
to be used
Treatment & disposal options
Red Contaminated Waste
(Recyclable)
(a) Wastes generated
from disposable items
such as tubing,
bottles,
intravenous tubes and
sets, catheters, urine
bags, syringes
(without
needles and fixed
needle
syringes) and
vaccutainers with their
needles cut) and
gloves
Red coloured non-chlorinated
plastic bags or containers
Autoclaving or micro-waving/
hydroclaving followed by shredding or
mutilation or combination of
sterilization and shredding. Treated
waste to be sent to registered or
authorized recyclers or for energy
recovery or plastics to diesel or fuel oil
or for road making, whichever is
possible.
Plastic waste should not be sent to
landfill sites.
43

44. Category Type of waste Type of bag or container
to be used
Treatment & disposal options
White
(translucent)
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
Autoclaving or dry heat sterilization
followed by shredding or mutilation or
encapsulation in metal container or
cement concrete; final disposal to iron
foundries or sanitary landfill or
designated concrete waste sharp pit
44

45. Category Type of waste Type of bag or container
to be used
Treatment & disposal options
Blue Glassware
(Broken or discarded
and
contaminated glass
including medicine vials
and ampoules except
those contaminated with
cytotoxic wastes.)
Cardboard boxes with blue
coloured marking
Disinfection or autoclaving or
microwaving or hydroclaving & then
sent for recycling
Metallic body implants
45

46. 46

47. 47

48. Good: Always fill only 3/4th binBad: Don’t overfill the bins

49. Good - Always carry the
waste in secure sealed
containers/ bags
Bad - Don’t carry waste in
open bags, and never carry it
through crowded areas

50. 50

51.  Schedule-II
standards for treatment & disposal of BMW
 Schedule-III
list of prescribed authorities and the
corresponding duties
51

52. 52

53. 53

54. 54

55. 55

56. MONTHLY TASKS- OCCUPIER
 Display of BMW report on web site
 Form II-Category
 Number of color coded bags with their weight
56

57. BIANNUAL TASK
 Meeting of biomedical waste management
committee
 Minutes of meeting
57

58. ANNUAL TASKS
 Training
 Health check up-immunization
 Submission of annual report form IV to
GPCB & displayed on web before 31th
January
 Submission of accident report in form I &
MOM to GPCB with annual report.( nil report
as well)
58

59. 59

60. PRE-TREATMENT & DECONTAMINATION
 Autoclaving
 Microwaving / Hydroclaving
 Chemical disinfection (H2O2, Gluteraldehyde,
Phenol, Per acetic acid etc. )
 Mutilation & shredding
60

61. DECONTAMINATION AND DISPOSAL OF SHARPS
 After use, needles and syringes should be
locally destroyed / cut by a needle destroyer
and these should be collected in a rigid
container
 Locate sharps disposal containers close to the
point of use e.g. in patient room, on the
medicine trolley and in the treatment room etc.
 Dispose used sharps in a puncture resistant
white container.
 Prevent overflow by sending sharps disposal
containers for autoclaving and shredding when
they are three quarters full.
61

62. FINAL DISPOSAL
 The black bags and waste therein is
dispensed along with other municipal waste.
 The bio-medical waste is collected and
disposed off.
 All the waste generated in the department is
sent to common waste collection site after
decontamination.
62

63. BURNING ISSUES
 Purchase of non chlorinated bags
 New poster, new bags & their training regarding
segregation, transportation
 Establish bar code system for bags
 Establish effluent system for liquid waste
 Formation of biomedical waste committee
 Biochemistry & pathology lab should start autoclaving
121°C x 20 lbs x 60 min. of blood vaccuttee then discard
in RED bag
 Blood bags to be autoclaved and discarded in yellow
bags.
 To check sambremky treatment and disposal facilities for
standards of incineration & for treatment
63

64. SUMMARY
 Bio medical waste categories are reduced
from 10 to 4.
 Change in color coding system
64

65. SUMMARY:
SCHEDULE- I
65

66. THANK YOU 66