Biomedical waste management

1. BIOMEDICAL WASTE
MANAGEMENT
RULES
WASTE MANAGEMENT
HIERARCHY
MOST PREFERABLE
LEAST
PREFERABLE
Dr. Ravindra Y M

2. WHY???
Biomedical Waste has the potential to spread infection &
it is a real problem for Environment and Human Health.
Improper disposal release high levels of U-POP’s (Dioxins
& Furans).
Biomedical Waste Management requires lifecycle
approach.
LET THE WASTE OF “THE SICK” NOT CONTAMINATE THE LIVES
OF “THE HEALTHY”

3. BIOMEDICAL WASTE STATISTICS
Developed Countries- 1-5 kg/bed/day (484 tons per day).
In India- 0.5-1 kg/bed/day (557 tons per day is generated by
approximately 2,38,170 HCF’s). Out of which only 57% waste
undergoes proper disposal.
In Karnataka about 66 tons/ per day of BMW is generated
including both public and private HCF’s.
In India- 198 CBMWTFs in operation and 28 are under
construction. 1,31,837 HCFs have MoU with CBMWTFs.
Karnataka ranks 2nd in the country having 25 CBMWTFs for
proper disposal of BMW and 3 more are under process.

4. WHAT IS BIOMEDICAL WASTE
“Biomedical 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 biologicals
or
in health camps, including the categories
mentioned in Schedule I appended to these rules;
?

5. CLASSIFICATION
NON-HAZARDOUS HAZARDOUS
80% 20%
Infectious &
Anatomical
Sharp
Waste
Chemicals &
Pharmaceutical
Waste
Genotoxic, Radioactive
& Waste with Heavy
Metal Content
15% 3% 1%
1%

6. DISEASES ASSOCIATED WITH BMW

7. WHO ARE ALL AT RISK?
Sanitation
Workers
Medical &
Paramedical
Staffs
Patient &
Patient
Attenders
General
Public
Environment
YOU & ME ARE AT RISK IN FIRST PLACE

8. LIFE CYCLE OF BMW
BMW
GENERATION
SEGREGATION AT
POG- 4 CCB
INTRAMURAL
TRANSPORTATION
SECURED STORAGE
AT TSR (≤48 HRS)
TRANSPORTATION TO
CBMWTF
FINAL TREATMENT
AT CBMWTF
DISPOSAL

9. TO IMPLEMENT LIFE CYCLE APPROACH……
Attitudinal change
Policy
Committee
SOP’s
Register & Records
Training

10. BMWMANAGEMENTPLAN
1. Assess present situation
and carry out a Waste
Survey
2. Identify Opportunities
for Minimization
3. Identify handling,
treatment and Disposal
Options
4. Estimate Related Costs
5. Prepare Immunization
Plan
6. Prepare a BMW
Management plan
7. Prepare Training Plan
8. Prepare Implementation
Strategy
9. Establish a Record
Keeping System
IF YOU ARE NOT MEASURING IT, YOU ARE NOT MANAGING IT
4 R - REDUCE, REUSE, RECYCLE, RECOVER
MOU WITH A CBMWTF COSTING & AUDITING

11. WHAT IS YOUR OPINION
ON THESE PICTURES ?
FRANK OPINION

15. BIOMEDICAL
WASTE
MANAGEMENT
RULES

16. BMWMRULES2016 &AMENDMENT2018
The Rule is applicable to all persons who Generates, Collects,
Receives, Stores, Transports, Treats, Disposes, or Handles the
Biomedical waste in any form including
 Hospital,
 Nursing Homes,
 Clinics,
 Dispensaries,
 Veterinary Institutions,
 Animal House,
 Pathological Laboratories,
 Blood Banks.
 Clinical Establishments,
Research or Educational
Institutions,
 Forensic Laboratories,
 Research Labs,
 AYUSH Hospitals,
 Health Camps, Medical/
Surgical Camps,
 Vaccination Camps,
 Blood Donation Camps.

17. OCCUPIER
MUST COMPLY
Segregation/
Containment
Storage &
disposal
Use Non-
Chlorinated
Bags
Pretreatment of
Lab/
Microbiological
Waste
Health
Checkup
Immunization
Maintenance of
Registers/Records
Training
Monthly /
Annual
Report
BMWM
Committee
DUTIES OF THE OCCUPIER- HCF

18. TEMPORARY STORAGE ROOM

19. Should be away from the Hospital main building but within the
hospital campus.
Should have impermeable flooring, color codes, water &
electricity supply with name board and visible Biohazrd symbol.
Should have good ventilation with mesh doors to prevent
rodent and cattle's entry.
Should have a motorable connecting road facility.
Should be under lock and key with a Supervisor appointed.
Should not be accessible to all hospital staffs.
Should maintain a register at TSR to record the quantum of
waste stored and handed over to CBMWTF.
TEMPORARY STORAGE ROOM SPECIFICATIONS

20. HEALTH RECORDS 21
SUPPLY OF HEALTH RECORDS FOR RECORDING HEALTH CHECKUPS
AT THE TIME OF INDUCTION & ANNUAL HEALTH CHECKUPS.

21. POSTER ON SEGREGATION OF BMW 22

22. SupplyofRegistersfordocumentation
23

23. 24
Register@TemporaryStorageroom

24. 25
INJURYREGISTER

25. 26
SUPPLYOFBMWRULEBOOK

27. NEW REQUIREMENTS
TIMELINE FOR
IMPLEMENTATION
REMARKS
Pre-treatment of laboratory waste,
microbiology waste, blood samples
before giving to Disposal Facility
*Immediate effect. -
Phase out chlorinated bags, gloves,
blood bags
Within 2 years from date
of issue for Principle BMW
2016 now extended to
27th March 2019
-
Training Healthcare workers about
handling of Biomedical waste
*Immediate effect
Details of training
to be submitted
along with Annual
report
Immunization of Healthcare workers
for Hepatitis B and Tetanus
*Immediate effect
Records of
vaccination to be
maintained.
TIMELINES FOR IMPLEMENTATION

28. 29
NEW REQUIREMENTS TIMELINE FOR IMPLEMENTATION REMARKS
Barcode system for bags or
containers containing Biomedical
waste
Within 1 year from date of issue of
Principle rules BMW 2016 now
extended to 27th March 2019
-
Health check up of Healthcare
Workers during induction and
annually there after.
*Immediate effect
Records to
be
maintained
Maintain and update Biomedical
Waste Management register and
monthly report on website
Within 2 years from date of issue
of Principle rule BMW- 2016 rules
i.e. within 28th March 2018
-
Major accidents to be reported
along with Annual Report
Should be documented and
reported
-
TIMELINES FOR IMPLEMENTATION

29. 30
NEW REQUIREMENTS TIMELINE FOR IMPLEMENTATION REMARKS
Maintain records of
autoclaving, Microwaving etc
for a period of five years
*Immediate effect -
Annual Report on website
Within 2 years from date of issue of
Principle Rules 2016 now extended to
16th March 2020.
-
Setup BMW Management
Committee, and meetings be
done bi- annually. Minutes to
be submitted in Annual
Report.
*Immediate effect -
TIMELINES FOR IMPLEMENTATION

30. INNOVATIVEMOBILEWASTETRANSPORTATIONTROLLEY

31. COMMON BIOMEDICALWASTETREATMENTFACILITY
Collection Vehicle
Incinerator
Sterilizer
Waste Water Treatment Plant

32. RED CATEGORY
YELLOW CATEGORY
BLUE CATEGORY
WHITE CATEGORY

33. 34
HUMAN ANATOMICAL WASTE
ORGANS, TISSUES, BODY PARTS, FETUS
NON CHLORINATED
PLASTIC BAGS
50 micron

34. 35
SOILED WASTE
Plaster, Dressings, Cotton Swabs, Face Mask, Shoe
Cover, Head Cap [Items contaminated with blood,
body fluids]

35. DISCARDED LINEN, MATTRESSES, BEDDINGS
CONTAMINATED WITH BLOOD OR BODY FLUID

36. MICROBIOLOGY, CLINICAL LABORATORY WASTE
[PRE TREAT WITH AUTOCLAVE]

37. HUMAN ANATOMICAL WASTE
SOILED WASTE
DISCARDED LINEN
MICROBIOLOGY, CLINICAL
LABORATORY WASTE
INCINERATION IN CBWTF

38. YELLOW
NON CHLORINATED
PLASTIC BAGS
50 micron
EXPIRED AND DISCARDED DRUGS
INCLUDING CYTOTOXIC DRUGS

39. RED CATEGORY
YELLOW CATEGORY
BLUE CATEGORY
WHITE CATEGORY

40. ALL RECYCLABLE PLASTICS INTO RED BIN
CATHETERS GLOVES
SYRINGES WITHOUT NEEDLES
VACCUTAINERS BOTTLES
URINE BAG
RED CATEGORY
RED LINERS NON –CHLORINATED
BIOHAZARD LOGO

41. RECYCLABLE
PLASTICS
AUTOCLAVE/
CBWTF (autoclave & shredding &
Recycled)

42. RED CATEGORY
YELLOW CATEGORY
BLUE CATEGORY
WHITE CATEGORY

43. BLUE CATEGORY
Glassware's & Metallic body & Dental implants

44. GLASSWARE’S
METALLIC IMPLANT
CBWTF-
AUTOCLAVE – RECYCLER

45. RED CATEGORY
YELLOW CATEGORY
BLUE CATEGORY
WHITE CATEGORY

46. ALL METALLIC SHARPS
BLADE SUTURE
NEEDLES
NEEDLES FROM
NEEDLE TIP CUTTER
SYRINGES WITH
FIXED NEEDLE
WHITE CATEGORY

47. METALLIC SHARPS
CBWTF- Autoclaving followed by Shredding or mutilation
or encapsulation in metal container or cement concrete
COLLECT – ONCE IT IS 3/4TH FULL

48. It is just not the law abide
compliance but the SOCIAL
RESPONSIBILITY of every Healthcare
Establishment and its Staffs (Doctors
till Non-Clinical Staffs) to SAY NO TO
HAZARDS OF BIOMEDICAL WASTE
It will only take few steps,
Proper Planning
Awareness,
Involvement of everyone,
Segregation at source,
Appropriate Storage,
Timely Disposal,
Registers & Record Maintenance
&
Finally ALL CLEAN