The document discusses healthcare waste and its management. It states that healthcare waste poses higher risks than other waste due to potential for infections. It also provides definitions of healthcare waste and categories such as infectious, sharp and pharmaceutical waste. The document outlines the major steps in healthcare waste management - segregation, collection, transportation, storage, treatment and disposal. It emphasizes the importance of proper waste handling and treatment to prevent health hazards.

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2. INTRODUCTION
The waste produced in the course of health care
activities carries a higher potential for infection
and injury than any type of waste. Therefore safe
and reliable method for its handling is essential.
Inappropriate methods in handling of health care
waste may have serious public health problems
and significant impact on health.

3. KEY FACTS
Of the total amount of waste generated by health-care activities,
about 85% is general, non-hazardous waste.
The remaining 15% is considered hazardous material that may be
infectious, toxic or radioactive.
Every year an estimated 16 billion injections are administered
worldwide, but not all of the needles and syringes are properly
disposed of afterwards.
Open burning and incineration of health care wastes can, under
some circumstances, result in the emission of dioxins, furans, and
particulate matter.

4. DEFINITION
According to bio-medical waste (management &
handling) rules, 1998 of India, “Biomedical waste is
a waste generated during the diagnosis, treatment
or immunization of human beings or animals or
research activities pertaining to or in production or
testing of biological” .

5. Any waste which is generated during the diagnosis ,
treatment or immunization of human beings or animals
Or
Research activities
Or
In the production or testing of biological
Or
In health camps
Waste generated during the diagnosis, testing, treatment,
research or production of biological products for human or
animals (WHO).

6. Types of waste
Infectious waste: waste contaminated with blood and other
bodily fluids (e.g. from discarded diagnostic samples), cultures
and stocks of infectious agents from laboratory work (e.g. waste
from autopsies and infected animals from laboratories), or
waste from patients with infections (e.g. swabs, bandages and
disposable medical devices);

7. Sharps waste: syringes, needles, disposable scalpels and
blades, etc.;
Chemical waste: for example solvents and reagents used for
laboratory preparations, disinfectants, sterilants and heavy
metals contained in medical devices (e.g. mercury in broken
thermometers) and batteries;

8. Pathological waste: human tissues, organs or fluids, body parts
and contaminated animal carcasses;
Pharmaceutical waste: expired, unused and contaminated drugs
and vaccines;
Cytotoxic waste: waste containing substances with genotoxic
properties (i.e. highly hazardous substances that are, mutagenic,
teratogenic or carcinogenic), such as cytotoxic drugs used in
cancer treatment and their metabolites;

9. Radioactive waste: such as products contaminated by
radionuclides including radioactive diagnostic material or
radiotherapeutic materials;
Non-hazardous or general waste: waste that does not pose
any particular biological, chemical, radioactive or physical
hazard.

10. WASTE CATEGORY EXAMPLE
Pathological waste Human tissue / fluids
Sharps Needles , Scalpels ,
Broken glass
Pharmaceutical waste Expired medicines
Genotoxic waste Cytotoxic drugs
Chemical waste Lab reagents, Dis-
infectants
Wastes with high content
of heavy metals
Batteries , Broken
thermometer
Pressurized containers Gas cylinders, Gas
catridges
Radio active waste Unused liquids from
radiotherapy
Infectious waste Lab cultures, waste from
isolation wards

11. Health care waste
Refers to all waste, biological or non biological that is
discarded and not intended for further use.
Health
care
waste Risk
waste
(10 –
25%)
Non risk
waste
(75 – 90%)
WHO estimates
85% of hospital waste in non hazardous
10% is infectious
5% is non infectious

12. SOURCES OF BIO MEDICAL WASTE
MAJOR SOURCES
•Hospitals
•Labs
•Research centers
•Animal research
•Blood bank
•Nursing homes
•Autopsy centers
MINOR SOURCES
•Clinics
•Home care
•Paramedics
•Funeral services
•Instituitions

14. THE MAIN GROUP AT RISK
Medical doctors Nurses

15. Health care auxillaries & hospital maintenance personnel
Patients in health care establishments
Visitors to health care establishments

16. Workers in support services allied to health
care establishment such as laundries, waste
handling & transportation

17. HAZARDS OF BIOMEDICAL WASTE
HAZARDS FROM INFECTIOUS WASTE AND SHARPS
Pathogens in infectious waste may enter the human body
by a number of routes.
Through a puncture, abrasion or cut in the skin
Through the mucus membrane
By inhalation
By ingestion

20. HAZARDS FROM CHEMICAL & PHARMACEUTICAL WASTE
Chemicals and pharmaceuticals account for about 3% of waste
from health-care activities.
They may be toxic, genotoxic, corrosive, flammable, reactive or
explosive.
Disinfectants: are particularly important members of this group;
they are used in large quantities and often corrosive.
Open burning of healthcare waste and incineration of plastics and
hazardous materials will generate at least 75 hazardous
chemicals as byproducts like oxides of sulphur & nitrogen, carbon
dioxide, dioxins ,furans etc.
Dioxins & furans are carcinogenic .

44. Bio medical waste management in India (Management & Handling)
Rules 1998, prescribed by ministry of environment and forests;
Government of India came into force on 28th july 1998. This rule
applies to those who generate, collect, receive, store, dispose, treat
or handle the biomedical waste in any manner. Waste are
differentiated into 10 categories , color code is also assigned.

49. STEPS OF BMW MANAGEMENT
SEGREGATION
COLLECTION
INTRAMURAL TRANSPORTATION
STORAGE (TEMPORARY)
TREATMENT
DISPOSAL

50. It means the separation of the mixed waste specifically at its
point of generation as per the color coding specified under
BMWM RULES 2016.
STEP 1: SEGREGATION

51. CATEGORY TYPE OF BAG/
CONTAINER
TYPE OF WASTE TREATMENT/
DISPOSAL OPTION

53. STEP 2: COLLECTION
Collection is the process of taking away the segregated
BMW from its every point of generation in an HCF to be
transported to the storage area with in the HCF.

54. Time of Collection
Bio-medical waste should be collected on daily basis from each ward
of the hospital at a fixed interval of time. There can be multiple
collections from wards during the day
HCF should ensure collection, transportation, treatment and disposal
of bio-medical waste as per BMWM Rules, 2016 and HCF should also
ensure disposal of human anatomical waste, animal anatomical waste,
soiled waste and biotechnology waste within 48 hours
General waste should not be collected at the same time or in the
same trolley in which bio-medical waste is collected.

55. Collection should be daily for most wastes, with collection timed to
match the pattern of waste generation during the day.
Bio-medical waste collected by the staff, should be provided with
PPEs.

56. PACKAGING
Bio-medical waste bags and sharps containers should be
filled to no more than three quarters full. Once this level is
reached, they should be sealed ready for collection.
Plastic bags should never be stapled but may be tied or
sealed with a plastic tag or tie.
 Replacement bags or containers should be available at
each waste-collection location so that full ones can
immediately be replaced.

57. Colour coded waste bags and containers should be
printed with the bio-hazard symbol, labelled with details
such as date, type of waste, waste quantity, senders
name and receivers details as well as bar coded label
to allow them to be tracked till final disposal.
 Ensure that Bar coded stickers are pasted on each
bag as per the guidelines

58. LABELING
All the bags/ containers/ bins used for collection and storage of bio-
medical waste, must be labelled with the Symbol of Bio Hazard or
Cytotoxic Hazard as the case may be as per the type of waste in
accordance with the BMWM Rules, 2016. Bio-medical waste bags /
containers are required to be provided with bar code labels in
accordance with CPCB guidelines for “Guidelines for barcode
System for Effective Management of Biomedical Waste”.

59. STEP 3: INTRAMURAL TRANSPORTATION

60. IN HOUSE TRANSPORTATION OF BIO MEDICAL
WASTE
Transportation Trolleys
In house transportation of Bio Medical Waste from site of waste
generation/ interim storage to central waste collection centre, within
the premises of the hospital must be done in closed trolleys /
containers preferably fitted with wheels for easy maneuverability.

61. ROUTE OF INTRAMURAL TRANSPORTATION OF
BIO-MEDICAL WASTE
Route of transportation preferably be planned in such a way
that:
Transportation does not occur through high risk areas
 Supplies and waste are transported through separate routes.
 Waste is not transported through areas having high traffic of
patients and visitors
Central Waste collection area can be easy accessed through
this route
Safe transportation of waste is undertaken to avoid spillage and
scattering of waste

62. STEP 4 : STORAGE (TEMPORARY)

63. INTERIM STORAGE
 Interim storage of bio medical waste is discouraged in the
wards / different departments of HCF.
 If waste is needed to be stored on interim basis in the
departments it must be stored in the dirty utility/sections.
 No waste should be stored in patient care area and
procedures areas such as Operation Theatre. All infectious
waste should be immediately removed from such areas.
 In absence of dirty utilities/ sections such BMW must be stored
in designated place away from patient and visitor traffic or low
traffic area.

64. CENTRAL WASTE COLLECTION ROOM FOR BIO-
MEDICAL WASTE
The location of central waste collection room must be away
from the public/ visitors access.
 The space allocation for this room must be as per the
quantity of waste generated from the hospital.
 The planned space must be sufficient so as to store at least
two days generation of waste.
 Central waste collection room must be roofed and manned
and should be under lock and key under the responsibility
of designated person

65. The entrance of this centre must be accessible through a
concrete ramp for easy transportation of waste collection
trolleys.
 Flooring should be of tiles or any other glazed material with
slope so as to ease the cleaning of the area.
 Exhaust fans should be provided in the waste collection room
for ventilation. It is to be ensured by the health care facility
that such central storage room is safety inspected for potential
fire hazard and based on such inspection preventive measure
has to be taken by the health care facility like installation of fire
extinguisher, smoke detector etc

66. There should also be provision for water supply adjacent to
central waste storage area for cleaning and washing of this
station and the containers. The drainage from the storage and
washing area should be routed to the Effluent Treatment Plant.
 Sign boards indicating relevant details such as contact person
and the telephone number should be provided.
 The entrance of this station must be labelled with “Entry for
Authorized Personal Only” and Logo of Bio Medical Waste
Hazard.
 It is to be ensured that no general waste is stored in the central
waste collection area.

67. CENTRAL STORAGE FOR HCF HAVING CAPTIVE
TREATMENT AND DISPOSAL SYSTEM
For the health care facilities which are having captive treatment
facility for treatment and disposal of biomedical waste through
incinerators, autoclaves/microwaves, shredders etc. within its
premises must ensure that waste generated from the HCF is
stored in this central waste collection area till it is transported to
reception area of captive waste treatment facility within the
premises.

68. STEP 5: TREATMENT
STEP 6: DISPOSAL

69. RECORD KEEPING
Every healthcare facility need to maintain the records w.r.to
category wise bio-medical waste generation and its treatment
disposal on daily basis.
Category wise quantity of waste generated from the facility must
be recorded in Bio Medical Waste Register/logbook being
maintained at central waste collection area under the supervision of
one designated person.
 A weighing machine as per the specifications given in CPCB
guidelines for bar code system needs to be kept in central waste
collection centre of the HCF having 30 or more than 30 nos. of
beds for weighing the quantity of Bio Medical Waste.

70. HCFs having less than 30 beds shall maintain records of
receipts printed by the CBWTF.
Records on Annual Report on bio-medical waste
management submitted to SPCB.
Records shall be maintained on training on BMW
Management including both Induction and in service training
records.
Maintain record on Immunization of all the employees.

71. UPDATING OF INFORMATION IN WEBSITE
Contact Address and details of the Healthcare Facility .
No. of beds
Details of :
 Authorisation under BMWM Rules, 2016
 Consent under Water (Prevention and Control of Pollution)
Act, 1974 and Air (Prevention and Control of Pollution) Act,
1981
 Quantity of bio-medical waste generation (in kg/day).
 Mode of disposal of bio-medical waste (through CBWTF or
through captive treatment facility).
 Name and address of the CBWTF through which waste is
disposed off (as applicable) .

72.  In case, HCF is having captive treatment facility,
a) bio-medical waste treated (in kg/day)
b) Details of treatment equipment
c)Total nos. and capacity of each treatment equipment (in kg/day)
d) Operating parameters of the treatment equipment as per
BMWM Rules, 2016
 Monthly records of bio-medical waste generation (category
wise)
 No. of trainings conducted on Bio-medical Waste
Management in the current year
 Stats of immunization of Health Care Workers involved in
handling of BMW