Biomedical Waste Managment

10 May 2010 ENGINEERING ASPECTS OF BIOMEDICAL
WASTE MANAGMENT

Medical Waste
Usually called Hospital ,Health Care Waste

Is defined as any waste generated at any
medical facility. It may consist of
pathological waste, infectious waste,
hazardous waste and general wastes.

Medical Waste is a sub set of Hospital Waste

Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010

Hospital waste management rules not implemented correctly
Lack of control over the Environmental protection
Wastes not segregated in many hospitals
Disposed off together with municipal solid waste
Openly burnt in some hospital
Medical waste segregation, recycling and reused by rag pickers
No specific legislation directly to medical waste
Poorly managed incinerators
No regulated disposal sites
Sharps collected/reused without cleaning or sterilization.
No clear classification of HCW & BMW
No color coding and types of containers for different categories and their
corresponding treatment & disposal option with standards
No polices &legislation dealing with hazardous waste
Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010 Jordanian Biomedical Engineering Center- Dr.Eng Walid Salameh Tarawneh May / 2010 BMW 10 May 2010

Dressings and swabs
Laboratory wastes
Instruments used in patient care
Potentially infectious materials : tissues, tumors ,organs removed during
surgery.
Potentially infected animals used in diagnostic or research studies
pathological waste - human tissues, organs, body parts removed during
surgery or autopsy or medical procedures and specimens of body fluids.
Potentially toxic waste
A. Radioactive – can be solid , liquids and gases used for analytical
procedures, body organ imaging and tumor localization and treatment.
Kitchen waste, office waste, wrapping papers and bouquets, etc. Kitchen waste - left B. Chemical waste - they may be hazardous toxic , corrosive, inflammable
over food , swill , peels and dirty water. ,reactive or genotoxic .they require safe disposal which will ensure that
human or environmental problems do not arise during storage, transport,
Bio-degradable waste – peels of fruits and vegetable skin and left over food and other and final disposal.
natural kitchen wastes. C. Pharmaceutical waste: surplus stock , spillage , or contamination is
Non Bio-degradable waste - wrappings foils plastic bags etc. detected or expiry date is over


Dr.Eng Walid Salameh Tarawneh lectures -
BMW

WASTE MANAGMENT

Others from In relation to production area
medical Biomedical Waste
hospital dept; Is defined as the waste generated during the diagnosis,
17% treatment or immunization of human beings or animals or
maternity; 8% in research activities pertaining there to or in the
production of testing Biologicals.
Orthopedic; 7%
Kitchen; 50% Biomedical waste is generated in different departments of the
hospital.
Surgical Dept;
4%
In health care settings,
Offices; 2%
about 85% of the waste generated is non hazardous
Others non about 10% is infectious ( OR, ISO- ROOMS , ER …etc)
medical
hospital dept; 5% non infectious but hazardous waste ( CHEM ,LAB , NM…etc)
12%
(Source : WHO Report- 2003)
Source : hospital waste , machado Jr., sobral G.M - DETESB

Category Waste
1 Human Anatomical (human tissues, organs, body parts)
2 Animal (experimental animals used in research)
Microbiology & Biotechnology (laboratory cultures, stocks or micro-organisms
3
, infectious agents ….. etc )
Radiological
4 Sharps (needles, syringes, scalpels, blade, glass) Waste
Radio -
5 Discarded Medicines & Cytotoxic Drugs pharmaceutic
als , Nuclear
Soiled (Contaminated with Blood & Body Fluids -cotton, dressings, soiled radio therapy
6
plaster casts, lines, bedding) and x-ray
chemical
7 Solid (Disposable Items other than sharps- tubings, catheters, intravenous sets)
Liquid (from laboratory and washing, cleaning, housekeeping and disinfecting
8
activities)
9 Incineration (Ash from incineration of any bio-medical waste)
10 Chemical (Chemicals used in production of biologicals, chemicals solutions )


BMW lab & blood bank
ICU, CCU
10% 8%
out patient Waste Minimization
OTHERS 6%
4% Segregation
ER
11%
Collection
Storage
Transportation
Treatment
Disposal
wards
48%
Infectious waste can cause diseases like Hepatitis, AIDS, etc.
When waste containing plastics are burnt, Dioxin is
OR +RECOVERY
13%
produced, which can cause Cancer, birth defects, hearing
defects.

BMW

WASTE MANAGMENT

The objective of BMW management always shall be to Bio-medical waste shall not be mixed with other wastes.
Bio-
reduce the risk and liabilities Bio-medical waste shall be segregated(Segregation at source – both at ward
Bio-
The main concepts should include the following and unit level) into containers/bags at the point of generation prior to its :
1. BMW should be managed through a pathway that includes : Generation , Storage
Segregation , Collection , Storage , Processing transport, Treatment and Transportation
Disposal Treatment
2. Where possible hazardous waste should be treated prior to disposal to Disposal
reduce and eliminate its hazard • The containers shall be labeled
3. BMW minimization and education should be the most desirable goal of • Transport waste safely to pick up site
waste management. This means : Material substitution, Waste segregation • Identify destination for each type of
, Recycling, Reuse, Procedural changes, Acquisition constrains and waste and ensure safe disposal
Treatment • Keep track of usage
4. The BMW management must includes Processes that Reduce a waste • Untreated BMW shall be transported only in vehicles authorized for the
amount or hazards purpose by the competent authority as specified by the government.

• Untreated BMW shall not be kept/stored beyond a period of 48 BMW shall be segregated into containers/bags at the point of
hours. generation, prior to its storage, transportation, treatment
and disposal.
• High considerations should be paid to the : These containers should be labeled and Colour Coded
Interest from senior management Colour Coding Type of Container Waste Category Treatment options
Ownership of the process Yellow Plastic Bag Categories 1, 2, 3 & 6. Incineration/ deep burial

Awareness of problems Red Disinfected container/Plastic bag Categories 3, 6, 7 Autoclaving/Micro-
waving/Chemical Treatment
Need for constant monitoring Blue/White Plastic Bag /punctproof containers Cat. 4, Autoclaving/Micro-waving/
Translucent Cat. 7 Chemical Treatment &
Segregation of waste to be taken seriously at user level
Destruction / shredding
Cost of color coding, staff, transport and disposal Black Plastic Bag Categories 5, 9, 10 Disposal in secured landfill.

Quantification of waste generated to be accurately done Notes
Protection of healthcare Patients , Healthcare workers , 1. Waste collection bags for waste types needing incineration shall not be made of
chlorinated plastics.
workers ,public and Community 2. Categories 8 and 10 (liquid) do not require containers/bags.
3. Category 3, if disinfected locally need not be put in containers/bags.
• Compliance with statutory requirements

Incineration
I. Double-
Double-chamber pyrolytic
incinerators
II. Single-chamber furnaces
Single-
III. Rotary kilns
To Min 800 C over an 12-h incinerating cycle.

Disinfection
Chemical disinfection
used for treating liquid waste
Thermal disinfection
generally used for treating solid waste


BMW

WASTE MANAGMENT

Sterilization
Steam sterilization I. Capacity & Cost.
autoclave used to disinfect waste. II. Types of waste treated.
Microwave irradiation uses III. Space requirements.
radiant energy to heat moisture within the Waste IV. Reduction of waste volume and mass.
Plasma arc technology V. Noise and odor.
Operates on principles of an electrical VI. Community and staff acceptance.
arc struck between two electrodes.
There is no burning and no formation of ash.
Landfill The cost of construction, operation and maintenance of system for managing
Open dumps : not recommended biomedical waste represents a significant part of overall budget of a hospital.
Sanitary landfills Two types of costs are required to be incurred by hospitals for BMW mgt
Disposing of certain types of BMW
(infectious waste and small quantities of is the cost for segregation, mutilation, disinfection, internal storage and
pharmaceutical waste) in sanitary landfills is transportation including hidden cost of protective equipment
acceptable
involves off site transport of waste, treatment and final disposal


Mostly chemical - collection-syringe needles, cotton swabs, blood, blood
bags, slides, gauze pieces, plastic tubes
Atmosphere Weighing
Marketing Recycling
Storage
Open
Gases
Special Special Container

collection Removal
Cementery
Unlabeled container

Plastic bags or Internal Reception
Identification Municipal
Segregation
Galvanized collection and cart Final storage Collection
improper

pins Ward wash
Waste No secondary Correct
Ward containment
Generation
storage
Incineration
Dilution Transport
manual

External
collection
storage Sewerage
Drainage
Channel

Radiological waste ≠ Radioactive waste NEWER TECHNOLOGIES ADOPTED FOR BMW
Radiological waste : x-ray film ,film fixers, NON INCINERATION TECHNOLOGY
developers…etc
AUTOCLAVING
Radioactive waste is material contaminated with
radioactive substances HYDROCLAVING
Radioactive waste must be stored in lead containers for a MICROWAVING
period of 10 half life of the waste before disposing
USE OF REUSABLES WHERE POSSIBLE INSTEAD
Radioactive waste is produced, during nuclear medicine,
radio immunoassay and bacteriological procedures OF DISPOSABLES
Radioactive waste, once lead shielded and allowed to SAFE SUBSTITUTES FOR MERCURY
decay to a safe level, is no longer deemed to be MODERNIZATION OF THE OPERATING PLANTS
radioactive waste.
IMPLEMENTING NEW ENGINEERING SOLUTION IN
In Isolation ward nuclear medicine dept. All patient radioactive
wastes are placed in a plastic bag and the bag is properly HOSPITAL DESIGNING & PLANNING
tagged.

BMW

WASTE MANAGMENT

A) Clean Materials B) Soiled Materials
The management of BMW should be start at the design -
planning phase of hospital planning and construction :
Determination of BMW types and sources within the new planned hospital
Determination of equipment and tools needed to collect , segregate , storage,
analyze, transport, treatment and disposal of BMW in each area in the planned
hospital
Estimating quantities and weights of BMW
Determination of Employer’s, management and Waste Management
Committee responsibilities
Establishing a clear BMW- mgt. working, monitoring and quality control
procedures
Establishment of the educational and training strategies From the The clean core
on a dedicated OR semi- To the
(SPD) cart lift or Surgical restricted "soiled"
Building the risk management policies "clean" side
of Supply
dedicated
clean elevator
procedure corridor side of SPD


1. building-up of a comprehensive system, address responsibilities,
resource allocation, handling and disposal
2. gradual improvements of the system and processes within it
3. Specific personnel need to be assigned to monitor the bio-
medical waste management in the hospital.
4. Man power needs and other resources for the BMWM of
hospital to be addressed.
5. Quality assessment of bio-medical waste management should be
done from time to time
6. Segregated collection and transportation - The use of color
coding and labeling of hazardous waste
7. Clear directives in the form of a posters and notice to be
displayed in all concerned areas
8. Taking care about Safety of handlers

8. Raising Awareness about risks related to health-care
waste; training staff and HCW on safe practices.
9. Selection of safe and environmentally friendly
management options, to protect people from hazards
when collecting, handling, storing, transporting, treating
or disposing of waste.
10. Issue of all protective clothes such as, gloves, aprons,
masks etc. to all HCW.
11. Regular medical check-up (half-yearly) of staff associated
with BMWM.
12. Maintenance of Record registers for this purpose.
13. Containers should be robust and leak proof
14. Tracking of Bio Medical Waste up to point of Disposal.
15. Proper treatment and final disposal.

BMW

Biomedical Waste Managment

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