1
“BIOMEDICAL WASTE MANAGEMENT-
REGULATORY COMPLAINCE &
MANAGEMENT OF BMW FACILITIES ”
Dr LAKSHMI RAGHUPATHY
Former Director, MoE&F
Adviser, Environment Managment
FAQ – BIOMEDICAL WASTES
• What is biomedical waste?
• Is bio-medical was infectious?
• Need for mgt of bio-medical wastes
• Why segregate?
• What does the color code signify?
• Why use separate containers?
• What is the safe method for Sharps disposal?
• What is the maximum storage time for BMW?
• What is Treatment & Disposal facility?
• What are the advantages of Common facility?
• How and where to locate facility ?
• How to transport BMW to common facility?
WHAT IS BIOMEDICAL WASTE?
 BIOMEDICAL WASTES are wastes, which
are generated during the diagnosis,
treatment or immunization of human beings
or animals or in research activities
pertaining thereto or in the production or
testing of biologicals and including
categories mentioned in Schedule 1
Bio-medical wastes are infectious and
hazardous - need to be managed carefully
BIOMEDICAL WASTES
REGULATIONS
• BIOMEDICAL WASTES (M&H) RULES 1998 - E(P)
ACT 1986 as amended in 2000, 2003
– MOE&F- NODAL AGENCY
– PRESCRIBED AUTHORITY-IMPLEMENTATION
These rules provide a system for regulating handling BMW which
includes collection, segregation at source, norms for packaging
labeling and options for treatment and disposal along with the
standard for treatment technologies.
– For proper management & Handling of Bio-Medical Waste.
– Applicable to all persons who generate, collect, receive,
store, transport, treat, dispose or handle bio-medical waste
in any form.
BIOMEDICAL WASTE HANDLING
(CRADLE TO GRAVE)
• CHARACTERIZATION
• QUANTIFICATION
• SEGREGATION
• STORAGE
• TRANSPORTATION
• TREATMENT
• DISPOSAL
BIOMEDICAL WASTE CATEGORIES
10 WASTE CATEGORIES
CAT1 HUMAN ANATOMICAL
CAT2 ANIMAL
CAT3 MICROBIOLOGY &BIOTECHNOLOGY
CAT4 WASTE SHARPS
CAT5 CYTOTOXICDRUGS & DISCARDED MEDICINES
CAT6 SOILDWASTE
CAT7 SOLID WASTE
CAT8 LIQUID WASTE
CAT9 INCINERATIONASH
CAT10 CHEMICAL
SEGREGATION , PACKAGING
TREATMENT & DISPOSAL
CATEGORY WASTE TYPE CONTAINER TREATMENT & DISPOSAL
1. HUMAN ANATOMICAL (Y P) INCINERATION/DEEP BURIAL
2. ANIMAL WASTE (Y,P) INCINEARTION/DEEP BURIAL
3. MICROBIOLOGY (Y,R) AUTOCLAVING/MICROWAVING
& BIOTECH /INCINERATION
4. WASTE SHARPS [B,W] DISINFECTION(CHEM)
/AUTOCL/MICRO/SHREDDING
5. DISCARDED MED INCINERATION/DESTRUCTION
& CYTO-Drugs [BLUE] /SECURED LANDFILL
6. SOILED (YELLOW) INCINERATION/AUTOCL
/MICROWAVING
7. SOLID [R,B,W] CHEM.DISINFEC/AUTOCL/MICROWAV/
(DISPOSABLES) SHREDDING
8. LIQUID CHEM DISINFEC & DISCHARGE INTO
DRAINS
9. INCINERATION ASH [Bl] MUNICIPAL LAND FILLS
10. CHEMICAL [Bl] CHEM TREATMENT DRAINS/ LANDFILL
BIOMEDICAL WASTES
REGULATIONS
• WASTE CAT 1,2,3 & 6 - YELLOW - PLASTIC BAGS
INCINERATION & BURIEL
• WASTE CAT 3,6 & 7 - RED-DISINFEC CONT &
PLASTIC BAGS
- CHEMICAL DIS. AUTOCL,
MICRO.
• CAT4 & 7 - BLUE /WHITE/TRANS-PLASTIC BAGS-
- - CHEMCIAL ,SHREDDING, AUTOCL,
MICRO,
• CAT5,9 &10 - BLACK-PLASTIC BAG
- SECURED LANDFILL
9
COMPLIANCE STATUS
Comprehensive Rules but poor compliance
there are many aspects in the rules that
required to be complied with
Authorisation not completed in many states
Storage provisions have not provided in most of
the heath care institutions
Dedicated vehicles for transportation of
biomedical wastes are not provided in many
states
Treatment disposal facilities have been set up
but not achieving prescribed Standards
10
BIO-MEDICAL WASTE MANAGEMENT
Steps taken by the States/UTs:
 Inventorization of all bio-medical waste
generators - hospitals, nursing homes, clinics etc.
 Ensure that hospitals seek authorisation.
 Action against violation of the rules
 Facilitate Creation of Common Treatment and
Disposal Facilities for Biomedical Waste.
Bio-Medical Waste (Management
& Handling) Rules,1998
• As per Rule 8 , Every Occupier of an institution
generating, collecting, receiving, storing,
transporting, treating, disposing and /or
handling bio-medical waste in any other manner,
except such occupier of clinics, dispensaries,
pathological laboratories, blood banks providing
treatment / service to less than 1000 (one
thousand) patients per month, shall make an
application in Form I to the prescribed
authority (DPCC) for grant of authorization.
12
DEADLINES FOR SETTING UP
BIOMEDICAL WASTE TREATMENT
FACILITIES
According to BMW Rules 1998 deadline for
setting up of treatment facilities:
 Metros with population >30 lakhs -30.06.2000
 Cities with population < 30 lakhs
 Hospitals and Nursing Homes >500 beds -30.06.2000
 Hospitals and Nursing Homes 200-500 beds -31.12.2000
 Hospitals and Nursing Homes 50-200 beds -31.12.2001
 Hospitals and Nursing Homes <50 beds -31.12.2002
 All others -31.12.2002
Operators of Common BMW
Treatment Facilities in Delhi
(CBMWTF)
• DPCC has authorized 2 Operators to create
Common BMW Treatment Facilities in Delhi
• 1. M/s Metro Bio- Care Waste Management
Pvt. Ltd., 55, Railway Road, Samaipur
Industrial Area, Delhi -42.
• 2. M/s Synergy Waste Management Pvt. Ltd,
Near Okhla STP, Sukhdev Vihar, Okhla, Delhi
-20.
• Both the Operators have been authorized for
collection of BMW from the Health Care Units
in Delhi, for transportation of collected waste
to the Common treatment site & for the
treatment as per BMW Rules.
COMMON BMW FACILITIES
• Facilties : Total - 157- Operation- 149
STATE FACILITIES STATE FACILITIES
AP 11 KARNATK 11
ASSAM 2 KERALA 1
BIHAR 3 MAHARSTR 34
CHANDGRH 1 MP 17
CHTTSGRH 5 MEGHALYA 1
DDNH 1 ORISSA 2
DELHI 2 PUNJAB 4
GUJARAT 12 RAJAST 6
HARYANA 3 TN 11
HP 2 UTTRACHL 2
J&K 2 UP 20
JHARKND 1 WB 4
15
OPTIMIZATION OF BIO-MEDICAL
WASTE MANAGEMENT
 Large health care units to have a treatment
disposal facility of their own
 Large units with spare capacity in their to be
shared with smaller units
 Treatment facilities to accept waste form small
waste generators .
 Common Treatment Disposal Facilities under PPP.
 Local medical association to assist in cooperative
ventures.
 State Govts. & municipal bodies to join hands
– Sites allotted for common incineration facilities
– Treated bio-medical wastes to be picked up by municipal
bodies.
16
NEWER APPROACHES FOR BMW
MANAGEMENT
Effective collection system to be put
in place within and outside health
care units
 Ensure proper segregation and
packaging
Pollution prevention thru EST
Waste reduction
Use of safe substitutes for
hazardous subs in use
17
NEWER TECHNOLOGIES
NEWER TECHNOLOGIES TO BE
ADOPTED FOR BMW
 NON INCINERATION TECHNOLOGY
[AUTOCLAVING & HYDROCLAVING &
MICROWAVING]
 USE OF REUSABLES WHERE POSSIBLE
INSTEAD OF DISPOSABLES
SAFE SUBSTITUTES FOR MERCURY
 MODERNIZATION OF THE OPERATING
PLANTS
REQUIEMENTS FOR BIOMEDICAL
WASTES MGT
• Facilitating the process of BMW Mgt
• Precautionary principles & preventive approach
• Training & awareness programmes
• Appropriate qualification & training
• Allocation of responsibilities
• Providing infrastructure and equipments
• Budget allocation
• Co-ordination and cooperation with other
institutions
ISSUES ON BIOMEDICAL WASTES
MANAGEMENT
ISSUES
• Adequate attention not given
• Indiscriminate Disposal
• Segregation Lacking
• Unscruplus Recycling
• No Treatment & Disposal Facility
• No Training Awareness
• Monitoring Mechanisms Lacking
• Lack of infrastructure in hospitals to tackle the problem
of bio-medical wastes.
• Inadequate/NIL allocation of funds.
• Lack of training for nurses and other para-medical staff.
• Absence of personal protective gears like gloves etc.,
while segregating and transporting wastes.
ACTION POINTS
SOLUTIONS
• Follow regulations
• Use re-usables
• Prescribe safe recycling
• Waste minimization
• Integral part of hospital management system
• Awareness & education
• Management monitoring mechanisms
• Penalty & punishments
• Utilisation of spare capacity of existing incinerators and
other facilities in the hospitals by small units. Also
utilisation of incinerators in the private sector industries
for treatment of Hospitals Wastes..
 Inclusion of Biomedical waste management as a part of
medical curriculum
21
Thank You

Biomedical waste management

  • 1.
    1 “BIOMEDICAL WASTE MANAGEMENT- REGULATORYCOMPLAINCE & MANAGEMENT OF BMW FACILITIES ” Dr LAKSHMI RAGHUPATHY Former Director, MoE&F Adviser, Environment Managment
  • 2.
    FAQ – BIOMEDICALWASTES • What is biomedical waste? • Is bio-medical was infectious? • Need for mgt of bio-medical wastes • Why segregate? • What does the color code signify? • Why use separate containers? • What is the safe method for Sharps disposal? • What is the maximum storage time for BMW? • What is Treatment & Disposal facility? • What are the advantages of Common facility? • How and where to locate facility ? • How to transport BMW to common facility?
  • 3.
    WHAT IS BIOMEDICALWASTE?  BIOMEDICAL WASTES are wastes, which are generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals and including categories mentioned in Schedule 1 Bio-medical wastes are infectious and hazardous - need to be managed carefully
  • 4.
    BIOMEDICAL WASTES REGULATIONS • BIOMEDICALWASTES (M&H) RULES 1998 - E(P) ACT 1986 as amended in 2000, 2003 – MOE&F- NODAL AGENCY – PRESCRIBED AUTHORITY-IMPLEMENTATION These rules provide a system for regulating handling BMW which includes collection, segregation at source, norms for packaging labeling and options for treatment and disposal along with the standard for treatment technologies. – For proper management & Handling of Bio-Medical Waste. – Applicable to all persons who generate, collect, receive, store, transport, treat, dispose or handle bio-medical waste in any form.
  • 5.
    BIOMEDICAL WASTE HANDLING (CRADLETO GRAVE) • CHARACTERIZATION • QUANTIFICATION • SEGREGATION • STORAGE • TRANSPORTATION • TREATMENT • DISPOSAL
  • 6.
    BIOMEDICAL WASTE CATEGORIES 10WASTE CATEGORIES CAT1 HUMAN ANATOMICAL CAT2 ANIMAL CAT3 MICROBIOLOGY &BIOTECHNOLOGY CAT4 WASTE SHARPS CAT5 CYTOTOXICDRUGS & DISCARDED MEDICINES CAT6 SOILDWASTE CAT7 SOLID WASTE CAT8 LIQUID WASTE CAT9 INCINERATIONASH CAT10 CHEMICAL
  • 7.
    SEGREGATION , PACKAGING TREATMENT& DISPOSAL CATEGORY WASTE TYPE CONTAINER TREATMENT & DISPOSAL 1. HUMAN ANATOMICAL (Y P) INCINERATION/DEEP BURIAL 2. ANIMAL WASTE (Y,P) INCINEARTION/DEEP BURIAL 3. MICROBIOLOGY (Y,R) AUTOCLAVING/MICROWAVING & BIOTECH /INCINERATION 4. WASTE SHARPS [B,W] DISINFECTION(CHEM) /AUTOCL/MICRO/SHREDDING 5. DISCARDED MED INCINERATION/DESTRUCTION & CYTO-Drugs [BLUE] /SECURED LANDFILL 6. SOILED (YELLOW) INCINERATION/AUTOCL /MICROWAVING 7. SOLID [R,B,W] CHEM.DISINFEC/AUTOCL/MICROWAV/ (DISPOSABLES) SHREDDING 8. LIQUID CHEM DISINFEC & DISCHARGE INTO DRAINS 9. INCINERATION ASH [Bl] MUNICIPAL LAND FILLS 10. CHEMICAL [Bl] CHEM TREATMENT DRAINS/ LANDFILL
  • 8.
    BIOMEDICAL WASTES REGULATIONS • WASTECAT 1,2,3 & 6 - YELLOW - PLASTIC BAGS INCINERATION & BURIEL • WASTE CAT 3,6 & 7 - RED-DISINFEC CONT & PLASTIC BAGS - CHEMICAL DIS. AUTOCL, MICRO. • CAT4 & 7 - BLUE /WHITE/TRANS-PLASTIC BAGS- - - CHEMCIAL ,SHREDDING, AUTOCL, MICRO, • CAT5,9 &10 - BLACK-PLASTIC BAG - SECURED LANDFILL
  • 9.
    9 COMPLIANCE STATUS Comprehensive Rulesbut poor compliance there are many aspects in the rules that required to be complied with Authorisation not completed in many states Storage provisions have not provided in most of the heath care institutions Dedicated vehicles for transportation of biomedical wastes are not provided in many states Treatment disposal facilities have been set up but not achieving prescribed Standards
  • 10.
    10 BIO-MEDICAL WASTE MANAGEMENT Stepstaken by the States/UTs:  Inventorization of all bio-medical waste generators - hospitals, nursing homes, clinics etc.  Ensure that hospitals seek authorisation.  Action against violation of the rules  Facilitate Creation of Common Treatment and Disposal Facilities for Biomedical Waste.
  • 11.
    Bio-Medical Waste (Management &Handling) Rules,1998 • As per Rule 8 , Every Occupier of an institution generating, collecting, receiving, storing, transporting, treating, disposing and /or handling bio-medical waste in any other manner, except such occupier of clinics, dispensaries, pathological laboratories, blood banks providing treatment / service to less than 1000 (one thousand) patients per month, shall make an application in Form I to the prescribed authority (DPCC) for grant of authorization.
  • 12.
    12 DEADLINES FOR SETTINGUP BIOMEDICAL WASTE TREATMENT FACILITIES According to BMW Rules 1998 deadline for setting up of treatment facilities:  Metros with population >30 lakhs -30.06.2000  Cities with population < 30 lakhs  Hospitals and Nursing Homes >500 beds -30.06.2000  Hospitals and Nursing Homes 200-500 beds -31.12.2000  Hospitals and Nursing Homes 50-200 beds -31.12.2001  Hospitals and Nursing Homes <50 beds -31.12.2002  All others -31.12.2002
  • 13.
    Operators of CommonBMW Treatment Facilities in Delhi (CBMWTF) • DPCC has authorized 2 Operators to create Common BMW Treatment Facilities in Delhi • 1. M/s Metro Bio- Care Waste Management Pvt. Ltd., 55, Railway Road, Samaipur Industrial Area, Delhi -42. • 2. M/s Synergy Waste Management Pvt. Ltd, Near Okhla STP, Sukhdev Vihar, Okhla, Delhi -20. • Both the Operators have been authorized for collection of BMW from the Health Care Units in Delhi, for transportation of collected waste to the Common treatment site & for the treatment as per BMW Rules.
  • 14.
    COMMON BMW FACILITIES •Facilties : Total - 157- Operation- 149 STATE FACILITIES STATE FACILITIES AP 11 KARNATK 11 ASSAM 2 KERALA 1 BIHAR 3 MAHARSTR 34 CHANDGRH 1 MP 17 CHTTSGRH 5 MEGHALYA 1 DDNH 1 ORISSA 2 DELHI 2 PUNJAB 4 GUJARAT 12 RAJAST 6 HARYANA 3 TN 11 HP 2 UTTRACHL 2 J&K 2 UP 20 JHARKND 1 WB 4
  • 15.
    15 OPTIMIZATION OF BIO-MEDICAL WASTEMANAGEMENT  Large health care units to have a treatment disposal facility of their own  Large units with spare capacity in their to be shared with smaller units  Treatment facilities to accept waste form small waste generators .  Common Treatment Disposal Facilities under PPP.  Local medical association to assist in cooperative ventures.  State Govts. & municipal bodies to join hands – Sites allotted for common incineration facilities – Treated bio-medical wastes to be picked up by municipal bodies.
  • 16.
    16 NEWER APPROACHES FORBMW MANAGEMENT Effective collection system to be put in place within and outside health care units  Ensure proper segregation and packaging Pollution prevention thru EST Waste reduction Use of safe substitutes for hazardous subs in use
  • 17.
    17 NEWER TECHNOLOGIES NEWER TECHNOLOGIESTO BE ADOPTED FOR BMW  NON INCINERATION TECHNOLOGY [AUTOCLAVING & HYDROCLAVING & MICROWAVING]  USE OF REUSABLES WHERE POSSIBLE INSTEAD OF DISPOSABLES SAFE SUBSTITUTES FOR MERCURY  MODERNIZATION OF THE OPERATING PLANTS
  • 18.
    REQUIEMENTS FOR BIOMEDICAL WASTESMGT • Facilitating the process of BMW Mgt • Precautionary principles & preventive approach • Training & awareness programmes • Appropriate qualification & training • Allocation of responsibilities • Providing infrastructure and equipments • Budget allocation • Co-ordination and cooperation with other institutions
  • 19.
    ISSUES ON BIOMEDICALWASTES MANAGEMENT ISSUES • Adequate attention not given • Indiscriminate Disposal • Segregation Lacking • Unscruplus Recycling • No Treatment & Disposal Facility • No Training Awareness • Monitoring Mechanisms Lacking • Lack of infrastructure in hospitals to tackle the problem of bio-medical wastes. • Inadequate/NIL allocation of funds. • Lack of training for nurses and other para-medical staff. • Absence of personal protective gears like gloves etc., while segregating and transporting wastes.
  • 20.
    ACTION POINTS SOLUTIONS • Followregulations • Use re-usables • Prescribe safe recycling • Waste minimization • Integral part of hospital management system • Awareness & education • Management monitoring mechanisms • Penalty & punishments • Utilisation of spare capacity of existing incinerators and other facilities in the hospitals by small units. Also utilisation of incinerators in the private sector industries for treatment of Hospitals Wastes..  Inclusion of Biomedical waste management as a part of medical curriculum
  • 21.