The document discusses biomedical waste management, outlining its definition, sources, types, hazards, and the management process, including classification and disposal methods. It emphasizes the importance of proper waste segregation and treatment in healthcare settings to minimize risks associated with infection and environmental contamination. Additionally, it mentions specific regulations for pandemic-related waste management and highlights the benefits of effective biomedical waste management for public health and the environment.

1. BIOMEDICAL WASTE MANAGEMENT
By
Dr Noor Mohamed Rasik .B
MBBS ,MD , D.Diab ,FDM ,CPCDM
Assistant Professor Community medicine and Diabetologist
Sri Lalithambigai Medical College and Hospital
Madhuravoyal ,Chennai

2. SPECIFIC LEARNING OBJECTIVES :
• To Define the term Bio-Medical Waste
• To List out the sources of Bio-Medical Waste
• To Classify the types of Bio-Medical Waste and its Hazards
• To Describe the Bio-Medical Waste Management Process
• To Enumerate the Bio-Medical Waste Management Rule

3. CONTENTS :
• Definition Bio-Medical waste
• Sources of BMW
• Types of BMW
• Hazards of BMW
• BMW Management Process
• BMW Management Rule,2016
• Spills
• BMW Management and COVID-19
• Benefits of BMW management
• Discussion

4. Introduction
• Waste of healthcare activities carry higher potential for infection and injury
than any other waste.
• Basic principle: Reduce, Recycle, Reuse
• Definition of Bio-Medical Waste :
“Any waste which is generated during the diagnosis, treatment or
immunization of human beings or animals or in research activities
pertaining thereto or in the production or testing biologicals”.

5. Biomedical Waste Statistics
• Developed countries 1-5kg/bed/day with variations among countries
• In INDIA :
1-2 kg/bed/day with variations among Govt and Private
establishments
Approximately 506.74 tons/day wastes generated
Out of which only 57% wastes undergoes proper disposal

6. SOURCES OF BIOMEDICAL WASTE

7. Sources of Bio-Medical waste

8. Major Sources

9. Minor Sources

10. TYPES OF BIOMEDICAL WASTE

11. Types of Bio medical waste
1)Infectious waste :Waste suspected to contain pathogens
Eg :Laboratory cultures ,waste from isolation wards ,materials or equipments that
have been in contact with infected patients
2)Pathological waste :Human tissue or fluids
Eg :Body parts ,blood and other body fluids

12. 3)Sharps :Sharp waste eg: Needle ,infusion sets ,scalpets ,knives ,blades
,broken glass etc
4)Pharmaceutical waste :Waste containing pharmaceuticals.
Eg :Pharmaceuticals that are expired or no longer needed ,items
contaminated by or containing pharmaceuticals (bottles , boxes )

13. 5)Genotoxic waste:Waste containing substances with genotoxic properties
Eg :Waste containing cytostatic drugs (often used in cancer
therapy),genotoxic chemicals
6)Chemical waste :Waste Containing chemical substances
Eg :Laboratory reagents ,disinfectants that are expired or no longer
needed ,solvents

14. 7)Wastes with high content of heavy metals :
Eg :Batteries ,Broken thermometers ,etc
8)Pressurized Containers :
Eg :Gas cylinders ,gas cartridges ,aerosol cans

15. 9)Radioactive waste :
Waste containing radioactive substances
Eg :Unused liquids from radiotherapy or laboratory
research ,contaminated glassware and packages

16. According to WHO Report :
Hospital wastes
• 85 % - Non Hazardous
• 10 % - Infective ,Hazardous
• 5 % - Non infective ,but Hazardous
(Chemicals ,Pharma substances , Radioactive )

17. Health Care Waste Generation

18. Who are at Risk ??

20. Hazards of Health Care Waste

21. BMW MANAGEMENT PROCESS

22. Biomedical Waste Management Process
A. Source Identification
B. Segregation
C. Collection and Storage
D. Transport
E. Treatment and Disposal

23. A)Source Identification
• Identification of source required both at
The Macro level
Institutes that generate waste
The Micro level
Points and activities within the institution

24. B)Segregation
• Segregation means “separation of different types of wastes by sorting or the
systematic separation of biomedical waste into designated categories ”
• Most important step as it helps to minimize the quantities of hazardous
waste and its associated risk

25. Bags once tied should not be re-opened

26. C)Collection and Storage
• Storage means “the holding of biomedical waste for period of time ,at the
end of which waste is treated and disposed of ”
• No untreated biomedical waste shall be kept stored beyond period of 48
hours
• If any reason it is necessary then permission of the prescribed authority is
essential

27. D)Transportation
• Transportation means “movement of biomedical wastes from the point
of generation or collection to the final disposal ”
• The container should have non-washable and prominently visible label
showing the type of waste it contains –Cytotoxic or Biohazards

28. Bio Medical wastes collection &Transport

29. Bio Medical wastes collection &Transport

30. E)Treatment and Disposal
• The main objectives of treatment are
o Disinfecting and decontaminating the waste and
oVolume reduction
• Broadly two categories
oBurn technology
oNon Burn technology

31. Treatment and Disposal Methods
1. Incineration
2. Chemical disinfection
3. Wet and dry thermal treatment (Autoclaving )
4. Microwave irradiation
5. Land disposal
6. Inertization

32. 1)Incineration
• Method of choice for most hazardous health care waste
• High temperature dry oxidation process
• Reduces organic and combustible waste to inorganic and incombustible
material
• Significant reduction in waste volume and weight

33. Incinerators

34. 2)Chemical disinfection
• Most suited for treating liquid waste such as infected blood ,urine ,stools or
hospital sewage
• Chemicals are added to waste to kill pathogens .

35. 3)Wet and dry thermal treatment (Autoclaving )
• Autoclaving is process of steam sterilization under pressure and used for
purpose of disinfecting and treating biomedical waste
• Effective inactivation of all the micro organism and bacterial spore at 121
degree C temperature and 30 pounds per square inch pressure for 3
minutes holding time

36. 4)Microwave irradiation
• Microorganisms are destroyed by the action of microwave at
-a frequency of about 2450 MHz and
-Wave length of 12.24 nm

37. 5)Land disposal
• Whatever may the modalities of waste treatment , final product has to be
taken to the land
• Two types of Land disposal
-Open dump
-Sanitary Land fill

38. 6)Inertization
• Mixing waste with cement and other substances before disposal
• Commonly used for pharmaceutical waste
• A typical proportion of mixture is-
-65 % of Pharmaceutical waste
-15 % lime
-15 % cement
-5 % water

39. BMW MANAGEMENT RULES

40. Biomedical Waste Management Rule
• Biomedical waste (Management and Handling )Rule 1998 –Ministry of
Environment and Forest ,Government of India -28th
July 1998
• This rule applies to those who generate , collect , receive , store , dispose ,
treat or handle bio-medical waste in any manner
• The Act is now superceded by Bio-Medical Waste Management Rule -28th
March 2016

41. Biomedical Waste Management Rule,2016
• 4 Schedules
• 4 Categories
• 5 Forms

42. Schedules of BMW Management

43. Schedule 1 (Part 1)

44. Schedule 1 (Part 2)
• All plastic bags shall be as per BIS Standards
• Chemical treatment – 10 % sodium Hypochlorite having 30% residual chlorine
for 20 minutes
• No chemical pre treatment before incineration ,except for microbiological , lab
waste
• Incinerated ash ,Residual chemical waste disposed by hazardous waste
• Dead foetus below viable period –Human anatomical waste
• Cytotoxic drug vials – back to manufacturer
• In –house incinerator not allowed
• Household BMW- separate bags- Municipal waste collection

45. Schedule IV Part A

46. Forms of BMW Management

51. Spills

52. 3 C ‘s in Spill Management
• Control
• Contain
• Clean up
Steps
1. Isolate the area
2. Obtain spill kit
3. Don PPE
4. Clean up the spill
5. Dispose of the waste as per
the standard guidelines

53. Blood spills
• Ensure Gloves are used before handling
• Cover the spill with absorbent cotton or cloth
• Disinfect the surface with 1% sodium hypochlorite solution / 5% phenol for
30 minutes
• Discard to Yellow bin
• Finally use the normal mop

54. Mercury Spill Respose
STEP 1 :Isolate and Ventilate
STEP 2 :Prepare to Respond
STEP 3 :Clean up
Use two pieces of cardboard –mercury beads together slowly
Using syringes collect smaller beads
All mercury in air tight container containing 20 ml of water
Place container in Zip lock cover
Collect minute beads with sticky tape and place it in a zip lock cover
Label the cover “Hazardous mercury waste &Handle with Care ”
STEP 4 :Disposal
STEP 5 :Hand Hygiene

55. Occupational Safety Measures :
All workers involved in the handling of hospital waste management must
provide
• PPE
• Conduct health check atleast once a year
• Provide training
• Immunization for protection against diseases like Hepatitis B ,Tetanus
• Report major accidents caused during handling of biomedical waste
• Records relevant thereto to prescribed authority

56. BMW Management Rule Shall not apply to

57. BMW Management and COVID -19

58. CPCB Guidelines
CPCB has revised biomedical waste management guidelines which has
specific requirements like:
• Use of double layered bags (using 2 bags) for collection of waste in corona
wards
• Use of dedicated collection bins labelled as “COVID-19” to store COVID-19
waste and kept separately in temporary storage room prior to handing over to
authorized staff
• Maintaining separate record of COVID waste
• Report opening or operation of COVID-19 sample collection centers and
• laboratories to concerned state pollution control board (SPCB)

59. CPCB Guidelines
• Goggles and Face Shields- Red Bin
• Disposable Mask, respirators, gowns -Yellow Bin
• In addition to mandatory labelling, bags/containers with biomedical
waste from COVID-19 wards, should be labelled as “COVID-19
Waste”, to enable CBWTFs to identify the waste easily for priority
treatment and disposal immediately upon the receipt
• Maintain separate record.
• Biomedical waste collected in such isolation wards can also be lifted
directly from ward into CBWTF collection van

61. Benefits of BMW Management
1)Positive health and Environment effects
• Reduces or eliminate the potential to transmit disease
• Eliminates dispersal of infectious waste into the environment
2)Enhanced Community image
• Demonstrates environmental consciousness
3)Economic advantages
• Volume reduction
• Savings in reduced cost and handling time
• Less personnel resources and storage space required

62. REFERENCES
1) k park. park's textbook of preventive and social medicine. 25th edition.
india. bhanot publishers. 2019 pg
2).AM Kadri IAPSM’S Textbook of Community Medicine 1st
Edition.Jaypee
brothers medical Publishers limited .2019 pg
3)Available from
file:///C:/Users/RASIK/AppData/Local/Temp/Pictorial_guide_covid-1.pdf
accessed on 25th
December 2021